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Hooshyari Z, Mohammadi MR, Salmanian M, Ahmadi N, Khaleghi A, Garakani A. Lifetime prevalence, comorbidities, and Sociodemographic predictors of post-traumatic stress disorder (PTSD): the National Epidemiology of Iranian Children and adolescents Psychiatric disorders (IRCAP). Eur Child Adolesc Psychiatry 2024:10.1007/s00787-024-02441-7. [PMID: 38656607 DOI: 10.1007/s00787-024-02441-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2023] [Accepted: 04/07/2024] [Indexed: 04/26/2024]
Abstract
OBJECTIVE The aims of this study were to (a) evaluate the lifetime prevalence of post-traumatic stress disorder (PTSD) according to sociodemographic characteristics, (b) determine sociodemographic factors associated with PTSD, (c) estimate the lifetime prevalence rates of comorbidities by age and gender, and (d) assess the proportion of traumatic events in the non-PTSD sample and the PTSD sample, according to gender. METHODS The data used for the present study were obtained from the IRCAP study which was a cross-sectional, community-based study on 29,250 children and adolescents aged 6-18 years from all provinces of Iran, which was done using multistage cluster sampling. Trained psychologists conducted diagnostic interviews with parents, children, and adolescents using the Persian version of the Kiddie Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime Version (K-SADS-PL). RESULTS In this study, the prevalence of PTSD across the sample population was 0.6% (95% CI, 0.5-0.7%). Higher rates of PTSD were observed among girls (0.7%, CI 0.5-0.8%), adolescents aged 15-18 years (0.8%, CI 0.6-1.0%), and participants who had unemployed (1.5%, CI 0.8-2.8%), or farmer fathers (1.1%, CI 0.5-2.5%). Of the participants with PTSD, 65.1% met the criteria for at least one other psychiatric disorder. PTSD had a high rate of comorbidity with oppositional defiant disorder (22.9%, CI 17.5-29.4%), generalized anxiety disorder (20.8%, CI 15.7-27.1%), separation anxiety disorder (20.3%, CI 15.2-26.6%), and major depressive disorder (19.8%, CI 14.8-26.0%). We found 9.5% of non-PTSD sample experienced at least one traumatic event. Witness to domestic violence was the most common traumatic event experienced by 32.8% of PTSD sample. CONCLUSION Our results in the prevalence, comorbidities, and sociodemographic factors associated with PTSD supported findings of previous studies that used a structured diagnostic interview. It is recommended to use purposive sampling and to investigate comorbidities of PTSD and type of traumatic events in a large clinical population.
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Affiliation(s)
- Zahra Hooshyari
- School of Psychology and Educational Sciences, University of Tehran, Tehran, Iran
| | - Mohammad Reza Mohammadi
- Psychiatry and Psychology Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Maryam Salmanian
- Psychiatry and Psychology Research Center, Tehran University of Medical Sciences, Tehran, Iran.
| | - Nastaran Ahmadi
- Yazd Cardiovascular Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Ali Khaleghi
- Psychiatry and Psychology Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Amir Garakani
- Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut, United States of America
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Giang C, Alvis L, Oosterhoff B, Kaplow JB. Protective Factors in the Context of Childhood Bereavement: Youth Gratitude, Future Orientation, and Purpose in Life. OMEGA-JOURNAL OF DEATH AND DYING 2024:302228241246919. [PMID: 38621174 DOI: 10.1177/00302228241246919] [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: 04/17/2024]
Abstract
The objective of the study was to examine potential associations between positive youth development constructs (gratitude, future orientation, purpose in life) and psychological functioning (posttraumatic stress symptoms, depressive symptoms, maladaptive grief reactions) among bereaved youth and test whether these associations vary by age. A diverse sample of 197 clinic-referred bereaved youth (56.2% female; M = 12.36, SD = 3.18; 36.1% Hispanic, 23.7% White, 20.1% Black, 11.9% Multiracial, and 8.2% another race/ethnicity) completed self-report measures of psychological functioning and positive youth development constructs. Linear regression models indicated that gratitude and purpose were associated with lower posttraumatic stress and depressive symptoms among bereaved youth. Future orientation was associated with higher posttraumatic stress symptoms. Results were consistent across age. If replicated longitudinally, gratitude and purpose may be important protective factors against negative mental health outcomes in the aftermath of losing a loved one.
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Affiliation(s)
- Christopher Giang
- Department of Health Behavior and Health Education, University of Michigan School of Public Health, Ann Arbor, MI, USA
| | - Lauren Alvis
- The Trauma and Grief Center, Meadows Mental Health Policy Institute, Houston, TX, USA
| | - Benjamin Oosterhoff
- The Trauma and Grief Center, Meadows Mental Health Policy Institute, Houston, TX, USA
| | - Julie B Kaplow
- The Trauma and Grief Center, Meadows Mental Health Policy Institute, Houston, TX, USA
- Department of Psychiatry, Tulane University School of Medicine, New Orleans, LA, USA
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McDonnell AS, Strayer DL. Immersion in nature enhances neural indices of executive attention. Sci Rep 2024; 14:1845. [PMID: 38253734 PMCID: PMC10803324 DOI: 10.1038/s41598-024-52205-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Accepted: 01/16/2024] [Indexed: 01/24/2024] Open
Abstract
There is conjecture that our modern urban environments place high demand on our attentional resources, which can become depleted over time and cause mental fatigue. Natural environments, on the other hand, are thought to provide relief from this demand and allow our resources to be replenished. While these claims have been assessed with self-report and behavioral measures, there is limited understanding of the neural mechanisms underlying these attentional benefits. The present randomized controlled trial fills this gap in the literature by using electroencephalography to explore three aspects of attention-alerting, orienting, and executive control-from a behavioral and neural perspective. Participants (N = 92) completed the Attention Network Task before and after either a 40-min walk in nature or a 40-min walk in a control, urban environment. Participants that walked in nature reported their walk to be more restorative than those that walked in the urban environment. Furthermore, the nature group showed an enhanced error-related negativity after their walk, an event-related brain component that indexes executive control capacity, whereas the urban group did not. These findings demonstrate that a 40-min nature walk enhances executive control at a neural level, providing a potential neural mechanism for attention restoration in nature.
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Affiliation(s)
- Amy S McDonnell
- Department of Psychology, University of Utah, Salt Lake City, UT, 84102, USA.
| | - David L Strayer
- Department of Psychology, University of Utah, Salt Lake City, UT, 84102, USA
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Jagtiani A, Gandhi R, Banga A, Blacker J, Joshi R, Bollu B, Kashyap R. Alpha-2 Agonists in Children and Adolescents With Post-traumatic Stress Disorder: A Systematic Review. Cureus 2024; 16:e53009. [PMID: 38410304 PMCID: PMC10895561 DOI: 10.7759/cureus.53009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2023] [Accepted: 01/26/2024] [Indexed: 02/28/2024] Open
Abstract
Exposure to traumatic stress is common among children. Post-traumatic stress disorder (PTSD) is a debilitating chronic mental disorder that can develop following exposure to a traumatic event. Psychopharmacological research in pediatric PTSD is limited. There is some evidence supporting the use of alpha-2 (α2) agonists for symptoms associated with PTSD. This systematic review identified published studies evaluating the effectiveness of α2 agonists in treating PTSD symptoms in children and adolescents. We conducted an extensive literature search on PubMed, MEDLINE, EMBASE, Cochrane Collaboration, and PsycINFO databases for published articles that evaluated the use of α2 agonists (clonidine and guanfacine) for treating symptoms of PTSD in children and adolescents. The study protocol was registered in Prospero (ID: CRD42021273692) and followed the PRISMA guidelines. A total of 10 published articles about clonidine or guanfacine use in PTSD in children and adolescents were identified. Studies found clonidine effective in reducing PTSD symptoms; however, the effects were variable. Clonidine and guanfacine showed effectiveness in treating nightmares, hyperarousal, aggression, and sleep disturbances and reducing re-experiencing, avoidant, and hyperarousal symptom clusters. No randomized, double-blind, placebo-controlled trials were found during the literature search. α2 agonists' effectiveness in treating symptoms associated with PTSD in children and adolescents is preliminary. Future placebo-controlled trials are needed to assess the efficacy and safety of α2 agonists.
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Affiliation(s)
- Amit Jagtiani
- Psychiatry, Burrell Behavioral Health, Springfield, USA
| | - Raghu Gandhi
- Psychiatry, Abbott Northwestern Hospital, Minneapolis, USA
| | - Akshat Banga
- Internal Medicine, Sawai Man Singh Medical College, Jaipur, IND
| | - Jacquetta Blacker
- Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis, USA
| | - Riecha Joshi
- Pediatrics, Government Medical College, Kota, Kota, IND
| | - Bhaswanth Bollu
- Emergency Medicine, All India Institute of Medical Sciences, New Delhi, IND
| | - Rahul Kashyap
- Medicine, Drexel University College of Medicine, Philadelphia, USA
- Global Clinical Scholars Research Training (GCSRT), Harvard Medical School, Boston, USA
- Research, Global Remote Research Program, Saint Paul, USA
- Critical Care Medicine, Mayo Clinic, Rochester, USA
- Research, WellSpan Health, York, USA
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Holloway TD, Harvanek ZM, Xu K, Gordon DM, Sinha R. Greater stress and trauma mediate race-related differences in epigenetic age between Black and White young adults in a community sample. Neurobiol Stress 2023; 26:100557. [PMID: 37501940 PMCID: PMC10369475 DOI: 10.1016/j.ynstr.2023.100557] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2023] [Revised: 06/29/2023] [Accepted: 07/14/2023] [Indexed: 07/29/2023] Open
Abstract
Black Americans suffer lower life expectancy and show signs of accelerated aging compared to other Americans. While previous studies observe these differences in children and populations with chronic illness, whether these pathologic processes exist or how these pathologic processes progress has yet to be explored prior to the onset of significant chronic illness, within a young adult population. Therefore, we investigated race-related differences in epigenetic age in a cross-sectional sample of young putatively healthy adults and assessed whether lifetime stress and/or trauma mediate those differences. Biological and psychological data were collected from self-reported healthy adult volunteers within the local New Haven area (399 volunteers, 19.8% Black, mean age: 29.28). Stress and trauma data was collected using the Cumulative Adversity Inventory (CAI) interview, which assessed specific types of stressors, including major life events, traumatic events, work, financial, relationship and chronic stressors cumulatively over time. GrimAge Acceleration (GAA), determined from whole blood collected from participants, measured epigenetic age. In order to understand the impact of stress and trauma on GAA, exploratory mediation analyses were then used. We found cumulative stressors across all types of events (mean difference of 6.9 p = 2.14e-4) and GAA (β = 2.29 years [1.57-3.01, p = 9.70e-10] for race, partial η2 = 0.091, model adjusted R2 = 0.242) were significantly greater in Black compared to White participants. Critically, CAI total score (proportion mediated: 0.185 [0.073-0.34, p = 6e-4]) significantly mediated the relationship between race and GAA. Further analysis attributed this difference to more traumatic events, particularly assaultive traumas and death of loved ones. Our results suggest that, prior to development of significant chronic disease, Black individuals have increased epigenetic age compared to White participants and that increased cumulative stress and traumatic events may contribute significantly to this epigenetic aging difference.
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Affiliation(s)
| | - Zachary M. Harvanek
- Department of Psychiatry, Yale University, New Haven, CT, USA
- Yale Stress Center, Yale University, New Haven, CT, USA
| | - Ke Xu
- Department of Psychiatry, Yale University, New Haven, CT, USA
- Department of Psychiatry, Connecticut Veteran Healthcare System, West Haven, CT, USA
| | | | - Rajita Sinha
- Department of Psychiatry, Yale University, New Haven, CT, USA
- Yale Stress Center, Yale University, New Haven, CT, USA
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Ruchkin V, Isaksson J, Stickley A, Schwab-Stone M. Longitudinal Associations Between Community Violence Exposure and Mental Health Problems in Inner-City Youth: Ethnicity and Gender Perspectives. JOURNAL OF INTERPERSONAL VIOLENCE 2023; 38:8619-8644. [PMID: 36915222 DOI: 10.1177/08862605231158754] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
There is a lack of agreement on whether children and adolescents with different cultural/ethnic backgrounds react to trauma in a similar fashion. This study adds to the existing literature by providing ethnicity and gender perspectives on the longitudinal associations between the degree of community violence exposure (CVE) and mental health problems in U.S. inner-city youth. The study was conducted on a representative sample of predominantly ethnic minority youth (N = 2,794; 54.1% female; age 11-16 years old (M [SD] = 12.77 [1.29]); 60.0% African-American, 26.1% Hispanic American, 13.9% White). Self-reported information was obtained on CVE in year 1 and on mental health problems (depressive symptoms, posttraumatic stress, alcohol use, and conduct problems) in year 1 and year 2. Multivariate analyses of covariance (MANCOVA) were used to compare mental health problems in youth from the three ethnic groups in relation to the different degrees of CVE experienced one year prior, while controlling for their baseline mental health problem levels, age, and socio-economic status. Mental health problems in year 2 increased in a similar fashion in relation to the degree of severity of CVE in year 1 in all three ethnic groups. The interaction effects suggested a gender-specific response to CVE, where girls in the three ethnic groups reported higher levels of depression and posttraumatic stress in relation to the same degree of CVE, as compared to boys. Adolescents from different ethnic backgrounds respond similarly to differing degrees of CVE with an increase in mental health problems over time. In response to a similar degree of exposure, girls tend to experience greater levels of internalizing problems than boys. Timely recognition of traumatic exposure and associated mental health problems is important for early prevention and intervention strategies.
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Affiliation(s)
- Vladislav Ruchkin
- Uppsala University, Sweden
- Yale University School of Medicine, New Haven, CT, USA
- Sala Forensic Psychiatric Clinic, Sweden
| | | | - Andrew Stickley
- National Institute of Mental Health, National Center of Neurology and Psychiatry, Kodaira, Tokyo, Japan
- Södertörn University, Huddinge, Sweden
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Sosnowski DW, Rojo-Wissar DM, Smail EJ, Musci RJ, Wilcox HC, Johnson SB. Expanding on Threat and Deprivation: Empirical Examination of Adversity Dimensions and Psychiatric Outcomes Among Emerging Adults. EMERGING ADULTHOOD (PRINT) 2023; 11:431-443. [PMID: 36969950 PMCID: PMC10038124 DOI: 10.1177/21676968221114260] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/06/2023]
Abstract
Dimensional models of adversity, whereby experiences lie along dimensions of threat and deprivation, are increasingly popular; however, their empirical validation is limited. In a sample of emerging adults (N=1,662; M age =20.72; 53% female; 72% Black), we conducted exploratory factor analyses using adversities derived from items probing family relationships and a validated assessment of traumatic events. Resulting factors were used to test associations with odds of lifetime diagnosis of a substance use disorder, other mental health disorders, and suicide attempt. Results supported a four-factor solution: threat (non-betrayal), emotional deprivation, sexual assault, and threat (betrayal). Threat (betrayal) summary scores were most strongly associated with increased odds of substance use and other disorders, whereas sexual assault was most strongly associated increased odds of lifetime suicide attempt. Findings provide some empirical support for categorizing adversity along dimensions of threat and deprivation. However, it also suggests the possibility of further divisions within these dimensions.
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Affiliation(s)
- David W Sosnowski
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health
| | | | - Emily J Smail
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health
| | - Rashelle J Musci
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health
| | - Holly C Wilcox
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health
| | - Sara B Johnson
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health
- Department of Pediatrics, School of Medicine, Johns Hopkins University
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Sbrilli MD, Jones JD, Kanine RM, Gallop R, Young JF. The Depression Prevention Initiative: Trauma as a Moderator of Prevention Outcomes. JOURNAL OF EMOTIONAL AND BEHAVIORAL DISORDERS 2022; 30:247-259. [PMID: 36353335 PMCID: PMC9640185 DOI: 10.1177/1063426620945665] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
Interpersonal Psychotherapy-Adolescent Skills Training (IPT-AST) is an evidence-based indicated depression prevention program that has been shown to reduce depression symptoms. Research is needed to identify moderators of IPT-AST's effects. Although trauma history has emerged as a moderator of depression treatment outcomes, the impact of trauma on short- and long-term outcomes in the context of preventive interventions for adolescent depression is unknown. This study examines the impact of trauma on prevention outcomes in a school-based randomized controlled trial (RCT) in which 186 adolescents (mean age = 14.01 years, SD = 1.22; 67% female) were randomly assigned to IPT-AST delivered by research staff or group counseling (GC) provided by school counselors. Trauma history significantly moderated intervention outcomes during the active phase of the intervention, but not during long-term follow-up. During the active phase, youth in IPT-AST with low or no trauma exposure experienced significantly greater reductions in depression symptoms than youth in GC with low or no trauma exposure, but there were no significant differences in rates of change between the two interventions for youth with high or any trauma exposure. These findings highlight the importance of assessing trauma and investigating whether these interventions can be tailored or supplemented to enhance the effects for youth with trauma exposure.
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Affiliation(s)
| | | | | | | | - Jami F. Young
- Children’s Hospital of Philadelphia, PA, USA
- University of Pennsylvania, Philadelphia, USA
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Sprang G, Garcia A. An Investigation of Secondary Traumatic Stress and Trauma-informed Care Utilization in School Personnel. JOURNAL OF CHILD & ADOLESCENT TRAUMA 2022; 15:1095-1103. [PMID: 36439655 PMCID: PMC9684366 DOI: 10.1007/s40653-022-00465-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 06/07/2022] [Indexed: 06/16/2023]
Abstract
Trauma-informed practices in schools are designed to address the impacts of trauma on students and increase supports for school personnel who are delivering this care The impact of a trauma-informed school-based intervention. Journal of Adolescence, 43, 142-147, Mendelsonet al., 2015. Research has established that professionals trained to implement the approach may have secondary traumatic stress (STS) reactions that could interfere with successful implementation (Stevens al., 2020). In this study it was hypothesized that increased use of trauma-informed care strategies would be associated with decreases in total STS scores, as well as all STS subscale scores at the end of a system's transformation initiative, controlling for sex, age, education, years worked in schools, and exposure to student trauma awareness at baseline. The Trauma Sensitive Schools Checklist (TSSC) and the Secondary Traumatic Stress Scale (STSS) were used to measure study outcomes in a sample of 205 school personnel at baseline and follow up. Statistically significant improvement in STSS scores and TSSC score were noted from Time 1 to Time 2. As hypothesized, improvements in TSSC scores were associated with decreased levels of STS over time, controlling for the covariates. However, the symptom domains of intrusion and arousal impacted this relationship in a differential manner than avoidance and alterations in cognitions and mood. This study provides evidence that increased use of trauma-informed care practices can positively impact the STS levels of school personnel, though special attention should be paid to those with high levels of intrusion or arousal.
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Affiliation(s)
- Ginny Sprang
- College of Medicine/Department of Psychiatry, University of Kentucky, Lexington, KY USA
- Center On Trauma and Children, 3470 Blazer Parkway Suite 100, Lexington, KY 40515 USA
| | - Antonio Garcia
- University of Kentucky College of Social Work, 655 Patterson Office Tower, Lexington, KY 40506 USA
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Peters W, Rice S, Alvarez-Jimenez M, Hetrick SE, Halpin E, Kamitsis I, Santesteban-Echarri O, Bendall S. Relative efficacy of psychological interventions following interpersonal trauma on anxiety, depression, substance use, and PTSD symptoms in young people: A meta-analysis. Early Interv Psychiatry 2022; 16:1175-1184. [PMID: 35106931 PMCID: PMC9786735 DOI: 10.1111/eip.13265] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Revised: 11/21/2021] [Accepted: 01/18/2022] [Indexed: 12/30/2022]
Abstract
AIM Interpersonal trauma exposures are associated with anxiety, depression, and substance use in youth populations (aged 12-25 years). This meta-analysis reports on the efficacy of psychological interventions on these symptom domains in addition to post-traumatic stress. METHODS Following PRISMA guidelines, a search of electronic databases was performed for randomized controlled trials (RCTs) assessing interventions for young people following interpersonal trauma exposure. Risk of bias was assessed using the Cochrane Risk of Bias tool. Data were analysed using random-effects meta-analyses. RESULTS Of the 4832 records screened, 78 studies were reviewed, and 10 RCTs, involving 679 participants (mean age 15.6 years), were analysed. There was a large pooled effect size for post-traumatic stress (7 studies, g = 1.43, 95% CI [0.37, 2.15], p = .002) and substance use (2 studies, g = 0.70, 95% CI [-0.11, 1.22], p < .001) and small effect sizes for anxiety (4 studies, g = 0.30, 95% CI [0.10, 0.49], p = .003), and trend-level effect for depression (10 studies, g = 0.27, 95% CI [0.00, 0.54], p = .052). Heterogeneity was significant for post-traumatic stress and moderate for depression. CONCLUSIONS High-quality RCTs of psychological interventions for anxiety, depression, substance use, and post-traumatic stress symptoms in young people exposed to interpersonal trauma are scarce. While available studies show either statistically significant or trend-level efficacy for psychological interventions in reducing these symptoms, wide confidence intervals, heterogeneity and small sample size mean that results need to be interpreted with caution.
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Affiliation(s)
- Wilma Peters
- Department of Research and Translation, Orygen, Parkville, Victoria, Australia.,Centre for Youth Mental Health, The University of Melbourne, Parkville, Victoria, Australia
| | - Simon Rice
- Department of Research and Translation, Orygen, Parkville, Victoria, Australia.,Centre for Youth Mental Health, The University of Melbourne, Parkville, Victoria, Australia
| | - Mario Alvarez-Jimenez
- Department of Research and Translation, Orygen, Parkville, Victoria, Australia.,Centre for Youth Mental Health, The University of Melbourne, Parkville, Victoria, Australia
| | - Sarah E Hetrick
- Department of Psychological Medicine, Faculty of Medicine and Health Sciences, University of Auckland, Auckland, New Zealand.,Centre for Youth Mental Health, University of Auckland, Auckland, New Zealand
| | - Emma Halpin
- Department of Research and Translation, Orygen, Parkville, Victoria, Australia.,Centre for Youth Mental Health, The University of Melbourne, Parkville, Victoria, Australia
| | - Ilias Kamitsis
- Department of Research and Translation, Orygen, Parkville, Victoria, Australia.,Centre for Youth Mental Health, The University of Melbourne, Parkville, Victoria, Australia
| | - Olga Santesteban-Echarri
- Hotchkiss Brain Institute, Department of Psychiatry, University of Calgary, Calgary, Alberta, Canada
| | - Sarah Bendall
- Department of Research and Translation, Orygen, Parkville, Victoria, Australia.,Centre for Youth Mental Health, The University of Melbourne, Parkville, Victoria, Australia
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Mu E, Thomas EHX, Kulkarni J. Menstrual Cycle in Trauma-Related Disorders: A Mini-Review. Front Glob Womens Health 2022; 3:910220. [PMID: 35706526 PMCID: PMC9189376 DOI: 10.3389/fgwh.2022.910220] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Accepted: 05/12/2022] [Indexed: 11/13/2022] Open
Abstract
Fluctuations of sex hormones across the menstrual cycle have been linked to exacerbation of symptoms of psychiatric disorders. Women diagnosed with trauma-related disorders such as post-traumatic stress disorder (PTSD) and borderline personality disorder (BPD) have reported worsening of mood symptoms at various phases of their menstrual cycle. There is also considerable overlap between PTSD, BPD, and complex-PTSD (cPTSD) symptoms, suggesting similar biological underpinnings. This mini-review examines the influence of sex hormones and the menstrual cycle on PTSD, BPD, and cPTSD symptoms, and discusses the involvement of the hypothalamic-pituitary-adrenal (HPA) axis. We review literature showing that PTSD and BPD symptoms fluctuate with the menstrual cycle, though the effect of the menstrual cycle phase appears to be inconsistent, warranting future research. Based on the reported phasic vulnerability in individuals with PTSD and BPD, it is plausible to assume that women diagnosed with the newly introduced cPTSD may experience similar difficulties. However, no study to date has addressed this. This review highlights the importance of considering an individual's trauma history as it may influence symptom severity and diagnosis, and the phase of the menstrual cycle at the time of diagnosis. This review also highlights that additional work is needed to clarify the influence of estradiol and progesterone fluctuations on trauma-related symptoms, especially in cPTSD. Continued research on menstrual cycle vulnerability and trauma will lead to better informed management and treatment of PTSD, BPD, and cPTSD.
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Kerbage H, Bazzi O, El Hage W, Corruble E, Purper-Ouakil D. Early Interventions to Prevent Post-Traumatic Stress Disorder in Youth after Exposure to a Potentially Traumatic Event: A Scoping Review. Healthcare (Basel) 2022; 10:healthcare10050818. [PMID: 35627955 PMCID: PMC9141228 DOI: 10.3390/healthcare10050818] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Revised: 04/19/2022] [Accepted: 04/25/2022] [Indexed: 12/04/2022] Open
Abstract
The worldwide occurrence of potentially traumatic events (PTEs) in the life of children is highly frequent. We aimed to identify studies on early mental health interventions implemented within three months of the child/adolescent’s exposure to a PTE, with the aim of reducing acute post-traumatic symptoms, decreasing long term PTSD, and improving the child’s adjustment after a PTE exposure. The search was performed in PubMed and EMBASE databases resulting in twenty-seven articles meeting our inclusion criteria. Most non-pharmacological interventions evaluated had in common two complementary components: psychoeducation content for both children and parents normalizing early post-traumatic responses while identifying post-traumatic symptoms; and coping strategies to deal with post-traumatic symptoms. Most of these interventions studied yielded positive results on outcomes with a decrease in post-traumatic, anxiety, and depressive symptoms. However, negative results were noted when traumatic events were still ongoing (war, political violence) as well as when there was no or little parental involvement. This study informs areas for future PTSD prevention research and raises awareness of the importance of psychoeducation and coping skills building in both youth and their parents in the aftermath of a traumatic event, to strengthen family support and prevent the occurrence of enduring post-traumatic symptoms.
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Affiliation(s)
- Hala Kerbage
- Department of Child and Adolescent Psychiatry, Saint Eloi University Hospital, 34090 Montpellier, France
- Center for Epidemiology and Population Health (CESP), INSERM U1018, Developmental Psychiatry Team, Paris-Saclay University, Villejuif CEDEX, 94807 Paris, France
- Correspondence: ; Tel.: +33601819449
| | - Ola Bazzi
- Faculty of Health Sciences, American University of Beirut, Beirut 1107 2020, Lebanon;
| | - Wissam El Hage
- Center of Clinical Investigation iBrain 1253, University of Tours, 37032 Tours, France;
| | - Emmanuelle Corruble
- CESP, MOODS Team, INSERM U1018, School of Medicine, Paris-Saclay University, Kremlin Bicetre, 94275 Paris, France;
- Department of Psychiatry, Paris-Saclay University Hospital, Kremlin Bicetre, 94275 Paris, France;
| | - Diane Purper-Ouakil
- Department of Psychiatry, Paris-Saclay University Hospital, Kremlin Bicetre, 94275 Paris, France;
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Ferrajão P, Elklit A. Attachment and social support mediate associations between polyvictimization and psychological distress in early Uganda and Kenya adolescents. CHILD ABUSE & NEGLECT 2021; 121:105271. [PMID: 34425466 DOI: 10.1016/j.chiabu.2021.105271] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Revised: 08/01/2021] [Accepted: 08/12/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND There is strong evidence that the experience of several potentially traumatic events (polyvictimization) is a risk factor for posttraumatic stress disorder (PTSD) and psychological distress among adolescents. The identification of the variables that influence the link between polyvictimization and PTSD and other psychiatric symptoms is warranted. OBJECTIVE We analyzed the associations between polyvictimization, PTSD symptoms (PTSS) and psychiatric symptoms in Kenya and Uganda adolescents, and explored the mediating roles of attachment orientations and perceived social support in the associations between polyvictimization, PTSS and psychiatric symptoms among adolescents from lower-middle-income countries (LALMIC). PARTICIPANTS AND SETTING A sample of 481 Kenyan adolescents (M = 16.28; SD = 1.878) and a sample of 408 Uganda adolescents (M = 15.95; SD = 1.377) completed validated self-report questionnaires. METHODS Serial multiple mediation models were tested by conducting a structural equation modelling employing Preacher and Hayes' procedures (2008). RESULTS Polyvictimization was related to higher PTSS and psychiatric symptoms. Importantly, polyvictimization was significantly linked to high attachment anxiety, which was linked with low perceived social support, which in turn was linked with high PTSS levels and psychiatric symptoms. CONCLUSIONS High levels of attachment anxiety might be connected with lack of perceived social support, which might be seen as a possible psychological distress mechanism subsequent to exposure to polyvictimization in adolescence from LALMIC.
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Affiliation(s)
- Paulo Ferrajão
- Faculdade de Ciências da Saúde e do Desporto, Universidade Europeia, Lisbon, Portugal.
| | - Ask Elklit
- National Center for Psychotraumatology, University of Southern Denmark, Odense, Denmark
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14
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Chen H, Hemmingsson T, Janszky I, Rostila M, Forsell Y, Meng L, Liang Y, László KD. Death of a parent during childhood and blood pressure in youth: a population-based cohort study of Swedish men. BMJ Open 2021; 11:e043657. [PMID: 33903141 PMCID: PMC8076918 DOI: 10.1136/bmjopen-2020-043657] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
OBJECTIVE Compelling evidence suggests that childhood adversities are associated with an increased risk of hypertension in middle age and old age. The link between childhood adversities and blood pressure in youth is less clear. In this cohort study, we examined the association between death of a parent during childhood and blood pressure in early adulthood in men. SETTING Sweden. PARTICIPANTS We studied 48 624 men born in 1949-1951 who participated in the compulsory military conscription in 1969/1970 in Sweden. Information on death of a parent during childhood was obtained from population-based registers. Information on covariates was obtained from the questionnaire and the clinical examination completed at conscription and from population-based registers. OUTCOME MEASURES Blood pressure was measured at conscription according to standard procedures. RESULTS The multivariable least square means of systolic and diastolic blood pressure did not differ between bereaved (128.25 (127.04-129.46) and 73.86 (72.89-74.84) mm Hg) and non-bereaved study participants (128.02 (126.86-129.18) and 73.99 (73.06-74.93) mm Hg). Results were similar when considering the cause of the parent's death, the gender of the deceased parent or the child's age at loss. Loss of a parent in childhood tended to be associated with an increased hypertension risk (OR and 95% CI: 1.10 (1 to 1.20)); the association was present only in case of natural deaths. CONCLUSION We found no strong support for the hypothesis that stress following the loss of a parent during childhood is associated with blood pressure or hypertension in youth in men.
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Affiliation(s)
- Hua Chen
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
| | - Tomas Hemmingsson
- Department of Public Health Sciences, Stockholm University, Stockholm, Sweden
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Imre Janszky
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
- Department of Public Health and General Practice, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway
| | - Mikael Rostila
- Department of Public Health Sciences, Stockholm University, Stockholm, Sweden
- Centre for Health Equity Studies, Stockholm University and Karolinska Institutet, Stockholm, Sweden
| | - Yvonne Forsell
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
- Centre for Epidemiology and Community Medicine, Stockholm County Council, Stockholm, Sweden
| | - Linghui Meng
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
- Statistical Office, Capital Institute of Pediatrics, Beijing, China
| | - Yajun Liang
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
| | - Krisztina D László
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
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15
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Piggott VM, Lloyd SC, Matchynski JI, Perrine SA, Conti AC. Traumatic Stress, Chronic Ethanol Exposure, or the Combination, Alter Cannabinoid System Components in Reward and Limbic Regions of the Mouse Brain. Molecules 2021; 26:2086. [PMID: 33917316 PMCID: PMC8038692 DOI: 10.3390/molecules26072086] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Revised: 04/01/2021] [Accepted: 04/03/2021] [Indexed: 12/17/2022] Open
Abstract
The cannabinoid system is independently affected by stress and chronic ethanol exposure. However, the extent to which co-occurrence of traumatic stress and chronic ethanol exposure modulates the cannabinoid system remains unclear. We examined levels of cannabinoid system components, anandamide, 2-arachidonoylglycerol, fatty acid amide hydrolase, and monoacylglycerol lipase after mouse single-prolonged stress (mSPS) or non-mSPS (Control) exposure, with chronic intermittent ethanol (CIE) vapor or without CIE vapor (Air) across several brain regions using ultra-high-performance liquid chromatography tandem mass spectrometry or immunoblotting. Compared to mSPS-Air mice, anandamide and 2-arachidonoylglycerol levels in the anterior striatum were increased in mSPS-CIE mice. In the dorsal hippocampus, anandamide content was increased in Control-CIE mice compared to Control-Air, mSPS-Air, or mSPS-CIE mice. Finally, amygdalar anandamide content was increased in Control-CIE mice compared to Control-Air, or mSPS-CIE mice, but the anandamide content was decreased in mSPS-CIE compared to mSPS-Air mice. Based on these data we conclude that the effects of combined traumatic stress and chronic ethanol exposure on the cannabinoid system in reward pathway regions are driven by CIE exposure and that traumatic stress affects the cannabinoid components in limbic regions, warranting future investigation of neurotherapeutic treatment to attenuate these effects.
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Affiliation(s)
- Veronica M. Piggott
- Research & Development Service, John D. Dingell VA Medical Center, Detroit, MI 48201, USA; (V.M.P.); (S.C.L.); (J.I.M.); (S.A.P.)
- Department of Psychiatry and Behavioral Neurosciences, Wayne State University School of Medicine, Detroit, MI 48201, USA
| | - Scott C. Lloyd
- Research & Development Service, John D. Dingell VA Medical Center, Detroit, MI 48201, USA; (V.M.P.); (S.C.L.); (J.I.M.); (S.A.P.)
- Department of Psychiatry and Behavioral Neurosciences, Wayne State University School of Medicine, Detroit, MI 48201, USA
| | - James I. Matchynski
- Research & Development Service, John D. Dingell VA Medical Center, Detroit, MI 48201, USA; (V.M.P.); (S.C.L.); (J.I.M.); (S.A.P.)
- Department of Psychiatry and Behavioral Neurosciences, Wayne State University School of Medicine, Detroit, MI 48201, USA
- Translational Neuroscience Program, Wayne State University School of Medicine, Detroit, MI 48201, USA
| | - Shane A. Perrine
- Research & Development Service, John D. Dingell VA Medical Center, Detroit, MI 48201, USA; (V.M.P.); (S.C.L.); (J.I.M.); (S.A.P.)
- Department of Psychiatry and Behavioral Neurosciences, Wayne State University School of Medicine, Detroit, MI 48201, USA
- Translational Neuroscience Program, Wayne State University School of Medicine, Detroit, MI 48201, USA
| | - Alana C. Conti
- Research & Development Service, John D. Dingell VA Medical Center, Detroit, MI 48201, USA; (V.M.P.); (S.C.L.); (J.I.M.); (S.A.P.)
- Department of Psychiatry and Behavioral Neurosciences, Wayne State University School of Medicine, Detroit, MI 48201, USA
- Translational Neuroscience Program, Wayne State University School of Medicine, Detroit, MI 48201, USA
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16
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Dias Campos F, Chambel MJ, Lopes S, Dias PC. Post-Traumatic Stress Disorder in the Military Police of Rio de Janeiro: Can a Risk Profile Be Identified? INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18052594. [PMID: 33807636 PMCID: PMC7967303 DOI: 10.3390/ijerph18052594] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/31/2021] [Revised: 02/28/2021] [Accepted: 03/01/2021] [Indexed: 11/24/2022]
Abstract
Background: Significant exposure to critical incidents characteristic of military police work has a potentially traumatic effect and multiple consequences for the mental health of these professionals, such as Post Traumatic Stress Disorder (PTSD). This study aims to investigate the occurrence of PTSD in this occupational group and its correlations with socio-demographic and occupational variables. Methods: This is a cross-sectional study of Rio de Janeiro’s Military Police officers (n = 3.577). Data was collected from self-reported questionnaires applied in an institutional health program. Post-Traumatic Stress Disorder Checklist—Civilian version was used to assess PTSD. Results: Rates of 16.9% for full PTSD and 26.7% for partial PTSD were found. Based on logistic regression analysis, female officers and police officers in lower ranks of the military hierarchy and performing administrative duties were found to be at most risk of developing PTSD. Conclusions: These results suggest the need to further understand the predictive organizational and individual variables of PTSD correlated with the increased vulnerability of professionals in order to contribute to institutional policies for the prevention and rehabilitation of these cases.
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Affiliation(s)
- Fernanda Dias Campos
- Military Police of the State of Rio de Janeiro, Rio de Janeiro 20031-040, Brazil;
- CICPSI, Faculdade de Psicologia, Universidade de Lisboa, 1649-013 Lisboa, Portugal; (M.J.C.); (S.L.)
| | - Maria José Chambel
- CICPSI, Faculdade de Psicologia, Universidade de Lisboa, 1649-013 Lisboa, Portugal; (M.J.C.); (S.L.)
| | - Sílvia Lopes
- CICPSI, Faculdade de Psicologia, Universidade de Lisboa, 1649-013 Lisboa, Portugal; (M.J.C.); (S.L.)
- Centre for Philosophical and Humanistic Studies, Faculty of Philosophy and Social Sciences, Universidade Católica Portuguesa, 4710-302 Braga, Portugal
| | - Paulo C. Dias
- Centre for Philosophical and Humanistic Studies, Faculty of Philosophy and Social Sciences, Universidade Católica Portuguesa, 4710-302 Braga, Portugal
- Correspondence:
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17
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Ellinghaus C, Truss K, Liao Siling J, Phillips L, Eastwood O, Medrano C, Bendall S. "I'm tired of being pulled from pillar to post": A qualitative analysis of barriers to mental health care for trauma-exposed young people. Early Interv Psychiatry 2021; 15:113-122. [PMID: 31957219 DOI: 10.1111/eip.12919] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2019] [Revised: 10/23/2019] [Accepted: 12/14/2019] [Indexed: 11/27/2022]
Abstract
AIM Traumatic experiences in childhood are pervasive and associated with a range of deleterious mental health outcomes. Despite this, trauma-exposed young people often do not seek help from mental health services. While barriers to care for general mental health concerns are well established, less is known about those specifically facing young people who have experienced trauma. The present paper sought to examine the barriers in seeking mental health care faced by trauma-exposed young people through a qualitative analysis of online forums where individuals discuss and seek informal support for trauma. METHODS This study used a qualitative, netnographic design, following the six-step LiLEDDa framework, developed for the analysis of online forums. Posts about trauma written in 2016 from five Internet forums targeting young people were included and analysed via thematic analysis. RESULTS Barriers to mental health care for trauma-exposed young people were categorized into two interrelated themes: (a) structural and (b) relational barriers. Structural barriers related to practical challenges faced when accessing and engaging with mental health services. Relational barriers focused on interpersonal relationships with mental health service providers and how these influenced experiences of, and consequent engagement with, services. CONCLUSIONS Trauma-exposed young people appear to experience multiple barriers to mental health care, whereby interactions between structural and relational barriers determine ongoing engagement. Service-wide reform including trauma-informed mental health training for practitioners is urgently needed to improve access to care and engagement for this vulnerable group.
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Affiliation(s)
- Carli Ellinghaus
- Orygen, Parkville, Victoria, Australia.,Centre for Youth Mental Health, The University of Melbourne, Parkville, Victoria, Australia
| | - Katie Truss
- Psychological Sciences, The University of Melbourne, Melbourne, Victoria, Australia
| | - Jocelyn Liao Siling
- Psychological Sciences, The University of Melbourne, Melbourne, Victoria, Australia
| | - Lisa Phillips
- Psychological Sciences, The University of Melbourne, Melbourne, Victoria, Australia
| | - Oliver Eastwood
- Orygen, Parkville, Victoria, Australia.,Centre for Youth Mental Health, The University of Melbourne, Parkville, Victoria, Australia
| | - Carmen Medrano
- Orygen, Parkville, Victoria, Australia.,Sant Joan de Deu Terres de Lleida Mental Health Service, Lleida, Spain.,Maimonides Institute of Biomedical Research of Cordoba (IMIBIC), Córdoba, Spain
| | - Sarah Bendall
- Orygen, Parkville, Victoria, Australia.,Centre for Youth Mental Health, The University of Melbourne, Parkville, Victoria, Australia
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18
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Young J, Schweber A, Sumner JA, Chang BP, Cornelius T, Kronish IM. Impact of prior trauma exposure on the development of PTSD symptoms after suspected acute coronary syndrome. Gen Hosp Psychiatry 2021; 68:7-11. [PMID: 33232851 PMCID: PMC7855440 DOI: 10.1016/j.genhosppsych.2020.11.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2020] [Revised: 10/22/2020] [Accepted: 11/06/2020] [Indexed: 12/22/2022]
Abstract
OBJECTIVE To determine the association between PTSD symptoms due to prior trauma and prior trauma type with PTSD symptoms after suspected acute coronary syndrome (ACS). METHOD A consecutive sample of patients presenting to the emergency department (ED) for suspected ACS were surveyed. Logistic regression was used to estimate the odds of elevated ACS-related PTSD symptoms [PCL-S ≥ 33] at 1-month associated with PTSD symptoms due to prior trauma and prior trauma type at the time of suspected ACS, adjusting for demographics, comorbidities, depression, and etiology of ACS symptoms. RESULTS Of 984 patients, 81.6% reported ≥1 prior trauma type and 22.5% reported PTSD symptoms due to prior trauma at the time of suspected ACS. One month later, 18.0% had ACS-related PTSD symptoms. Patients with versus without PTSD symptoms due to prior trauma at the time of the suspected ACS had increased odds of ACS-related PTSD symptoms one month later (42.1% vs 9.9%; aOR 4.49, 95% CI:3.05-6.60; p < .001). Prior life-threatening illness was the only trauma type significantly associated with ACS-related PTSD symptoms (aOR 1.57, 95% CI:1.03-2.39; p = .04). CONCLUSIONS PTSD symptoms from prior trauma and history of life-threatening medical illness at the time of suspected ACS increased risk of ACS-related PTSD symptoms one month later.
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Affiliation(s)
- Justin Young
- Center for Behavioral Cardiovascular Health, Columbia University Irving Medical Center, 622 W. 168th St, NY, New York, USA; Columbia University Vagelos College of Physicians and Surgeons, 630 W. 168th St, NY, New York, USA
| | - Adam Schweber
- Center for Behavioral Cardiovascular Health, Columbia University Irving Medical Center, 622 W. 168th St, NY, New York, USA; Columbia University Vagelos College of Physicians and Surgeons, 630 W. 168th St, NY, New York, USA
| | - Jennifer A Sumner
- Center for Behavioral Cardiovascular Health, Columbia University Irving Medical Center, 622 W. 168th St, NY, New York, USA; Department of Psychology, University of California Los Angeles, 1285 Franz Hall, Box, 951563, Los Angeles, CA, USA
| | - Bernard P Chang
- Department of Emergency Medicine, Columbia University Irving Medical Center, 622 W. 168th St, NY, New York, USA
| | - Talea Cornelius
- Center for Behavioral Cardiovascular Health, Columbia University Irving Medical Center, 622 W. 168th St, NY, New York, USA
| | - Ian M Kronish
- Center for Behavioral Cardiovascular Health, Columbia University Irving Medical Center, 622 W. 168th St, NY, New York, USA.
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19
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Mance GA, Rodgers CRR, Roberts D, Terry A. Deeply Rooted: Maximizing the Strengths of a Historically Black University and Community-based Participatory Research to Understand Environmental Stressors and Trauma among Black Youth. AMERICAN JOURNAL OF COMMUNITY PSYCHOLOGY 2020; 66:256-266. [PMID: 32783253 DOI: 10.1002/ajcp.12452] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
This paper explores a partnership between an HBCU (Historically Black Colleges and Universities) and a community to understand trauma given the high rates of reported violence among youth locally. The accumulative stress of living in high-stress, high-poverty environments coupled with the normative developmental tasks of adolescence is thought to place these youths at risk for negative mental and physical outcomes (Murry et al., 2011). The current research uses a community-based participatory research (CBPR) approach and developmental lens to better understand environmental stressors and subsequent trauma among Black youth. Specifically, the paper describes the recruitment, engagement, and equitable partnership between a youth advisory board (YAB), university research team, and community agencies advisory board (CAB). The current work is part of a larger research study designed to explore environmental stressors, coping, and social supports for Black youth residing in low-resource urban communities. The broad objective of the research is to develop a trauma-informed community intervention to improve adolescent mental health. The initial phase of this university-community research, which entails the YAB, CAB, and university discussion groups, is outlined in this paper. Community engagement and trust are key factors described in the literature when collaborating with communities of color. These themes were reiterated by research partners in this study. The research team created coding terms to identify themes from YAB and CAB transcript data, respectively. YAB themes regarding stressors centered around financial strain, anger, and loss/violence. CAB themes regarding adolescent mental health and resources centered around trauma, trust, and sustainability. Initial steps to utilize the themes identified thus far are described. The unique advantages of an HBCU and CBPR to address mental health disparities in ethnic minority communities are also highlighted.
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Affiliation(s)
- GiShawn A Mance
- Department of Psychology, Howard University, Washington, DC, USA
| | - Caryn R R Rodgers
- Division of Academic General Pediatrics, Department of Pediatrics, Albert Einstein College of Medicine, The Bronx, NY, USA
| | - Debra Roberts
- Department of Psychology, Howard University, Washington, DC, USA
| | - Amanda Terry
- Department of Psychology, Howard University, Washington, DC, USA
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20
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Cole AR, Jaccard J, Munson MR. Young adult trauma symptoms in the context of community violence exposure. JOURNAL OF COMMUNITY PSYCHOLOGY 2020; 48:2517-2531. [PMID: 32906193 DOI: 10.1002/jcop.22437] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/31/2020] [Accepted: 07/28/2020] [Indexed: 06/11/2023]
Abstract
AIMS The primary purpose of this study is to understand how community violence exposure is associated with both common and unique variance characterizing posttraumatic stress (PTS) symptoms among young adults living in a low-resourced setting. METHODS Data were collected using a cross-sectional survey design. Participants were recruited from public housing developments in a city in the eastern United States. Participants completed a survey that included questions related to community violence, PTS symptoms, and optimism. Data were analyzed using structural equation modeling. RESULTS We found a relationship between a generalized PTS response and each of the PTS symptom categories. Experiencing community violence was significantly related to generalized PTS response over and above other traumatic events. CONCLUSION Young adults who experience community violence have a general distress response to those experiences, and yet, beyond that general response, there are ways in which each symptom is distinct from a generalized distress reaction.
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Affiliation(s)
- Andrea R Cole
- New York University Silver School of Social Work, New York City, New York, USA
| | - James Jaccard
- New York University Silver School of Social Work, New York City, New York, USA
| | - Michelle R Munson
- New York University Silver School of Social Work, New York City, New York, USA
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21
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Zerach G, Elklit A. Polyvictimization and Psychological Distress in Early Adolescence: A Mediation Model of Defense Mechanisms and Coping Styles. JOURNAL OF INTERPERSONAL VIOLENCE 2020; 35:4732-4756. [PMID: 29294815 DOI: 10.1177/0886260517716944] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
In the current study, we aim to examine the link between exposure to multiple traumatic events (polyvictimization), posttraumatic stress disorder (PTSD) symptoms (PTSS), and psychiatric symptomatology in early adolescence. Furthermore, we aim to explore the mediating roles of defense styles and coping styles in the associations between polyvictimization, PTSS, and psychiatric symptomatology. Data from a Danish national representative sample of 390 eighth-grade students with a mean age of 13.95 (SD = 0.37) years were used. Participants responded to validated self-report questionnaires in 2001. The dimensions of immature defense styles and emotional and avoidance coping mediated the positive associations between polyvictimization, PTSS, and psychiatric symptomatology. Serial multiple mediation indicated that the sum of exposure to traumatic events was significantly associated with more immature defense styles, associated with both high levels emotional and avoidance coping, which, in turn, were associated with high levels of PTSS and psychiatric symptomatology. Polyvictimization is related to adverse outcomes in early adolescence. Both immature defense styles and emotional and avoidance coping styles should be considered as risk factors for the development of psychological distress following exposure to multiple traumas.
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Affiliation(s)
| | - Ask Elklit
- University of Southern Denmark, Odense, Denmark
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22
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Ralevski E, Southwick S, Petrakis I. Trauma- and Stress-Induced Craving for Alcohol in Individuals Without PTSD. Alcohol Alcohol 2020; 55:37-43. [PMID: 31812999 DOI: 10.1093/alcalc/agz092] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2019] [Revised: 09/27/2019] [Accepted: 09/28/2019] [Indexed: 11/14/2022] Open
Abstract
AIMS The main objective of the study was to compare the differences in craving following trauma and stress scripts in individuals with alcohol dependence (AD) who have experienced trauma but did not meet criteria for post-traumatic stress disorder (PTSD). METHODS Twenty-eight men and women who participated in a treatment trial were included in this study before starting treatment. All had to meet criteria for AD and had experienced trauma at some point of their lives but were never diagnosed with PTSD. All participants had one laboratory session and were exposed to stress, trauma and neutral scripts randomly assigned. Main measures of craving, anxiety and mood were administered before, during and after each script. RESULTS Stress and trauma scripts induced significantly more craving and anxiety than the neutral scripts. Interestingly, stress scripts produced stronger craving and anxiety than the trauma scripts but only with some measures. Stress and trauma scripts produced significantly more fear, anger and sadness and significantly lower ratings of joy and relaxation than the neutral script. Again, there were no differences between stress and trauma scripts for any of the emotional subscales. CONCLUSIONS Trauma scripts did not result in stronger craving than stress scripts. These findings suggest that trauma in the absence of PTSD diagnosis does not lead to stronger craving for alcohol.
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Affiliation(s)
- Elizabeth Ralevski
- Department of Psychiatry, Yale University School of Medicine, 300 George St. New Haven, CT 06511, USA.,Department of Veterans Affairs, VA Connecticut Healthcare System, Psychiatry Service (116A), 950 Campbell Ave, West Haven, CT 06516, USA.,Mental Illness Research and Clinical Center, VA Connecticut Healthcare System, 950 Campbell Ave West Haven, CT 06516, USA
| | - Steven Southwick
- Department of Psychiatry, Yale University School of Medicine, 300 George St. New Haven, CT 06511, USA.,Department of Veterans Affairs, VA Connecticut Healthcare System, Psychiatry Service (116A), 950 Campbell Ave, West Haven, CT 06516, USA
| | - Ismene Petrakis
- Department of Psychiatry, Yale University School of Medicine, 300 George St. New Haven, CT 06511, USA.,Department of Veterans Affairs, VA Connecticut Healthcare System, Psychiatry Service (116A), 950 Campbell Ave, West Haven, CT 06516, USA.,Mental Illness Research and Clinical Center, VA Connecticut Healthcare System, 950 Campbell Ave West Haven, CT 06516, USA
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23
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Mangelsdorf SN, Conroy R, Mehl MR, Norton PJ, Alisic E. Listening to Family Life After Serious Pediatric Injury: A Study of Four Cases. FAMILY PROCESS 2020; 59:1191-1208. [PMID: 31506948 DOI: 10.1111/famp.12490] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Following a serious child injury, the entire family can be affected. Gaining an understanding of family support, interactions, and stress levels can help clinicians tailor treatment. Presently, these factors are assessed mainly via self-reports and structured observations. We aimed to explore the value of naturalistic observation of postinjury parent-child interactions, in order to highlight how clinicians might use these data in their practice. Our qualitative study involved an in-depth analysis of four cases from the Ear for Recovery project, against the backdrop of the larger sample's characteristics. Children who had been hospitalized with a serious injury wore the Electronically Activated Recorder (EAR). Over a two-day period postdischarge, the EAR recorded 30-second audio "snippets" every 5 minutes. Families also completed self-report measures on family functioning, child stress and social support, parent stress, optimism, and self-efficacy. For each case, two coders independently used an ethnographic method, integrating self-report measures, family and injury characteristics, audio recordings, and transcripts to mimic integration of information within clinical practice. The coders then reached consensus on the main themes for each case through discussion. Families showed substantial variation in their communication in terms of content, tone, and frequency, including moments of conflict, humor, and injury-related conversations. We explored how these recorded interactions converged with and diverged from the self-report data. The EAR provided an opportunity for rich descriptions of individual families' communication and activities, yielding potential clinical information that may be otherwise difficult or impractical to obtain.
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Affiliation(s)
- Shaminka N Mangelsdorf
- School of Psychological Sciences, Monash University, Melbourne, Vic., Australia
- Monash University Accident Research Centre, Monash University, Melbourne, Vic., Australia
- Murdoch Children's Research Institute, Melbourne, Vic., Australia
| | - Rowena Conroy
- Murdoch Children's Research Institute, Melbourne, Vic., Australia
- Melbourne School of Psychological Sciences, The University of Melbourne, Melbourne, Vic., Australia
- The Royal Children's Hospital, Melbourne, Vic., Australia
| | | | - Peter J Norton
- School of Psychological Sciences, Monash University, Melbourne, Vic., Australia
| | - Eva Alisic
- Monash University Accident Research Centre, Monash University, Melbourne, Vic., Australia
- Murdoch Children's Research Institute, Melbourne, Vic., Australia
- Jack Brockhoff Child Health and Wellbeing Program, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Vic., Australia
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24
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Last BS, Rudd BN, Gregor CA, Kratz HE, Jackson K, Berkowitz S, Zinny A, Cliggitt LP, Adams DR, Walsh LM, Beidas RS. Sociodemographic characteristics of youth in a trauma focused-cognitive behavioral therapy effectiveness trial in the city of Philadelphia. JOURNAL OF COMMUNITY PSYCHOLOGY 2020; 48:1273-1293. [PMID: 31872896 PMCID: PMC7261621 DOI: 10.1002/jcop.22306] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/14/2019] [Revised: 10/25/2019] [Accepted: 12/05/2019] [Indexed: 05/13/2023]
Abstract
While randomized controlled trials of trauma-focused cognitive behavioral therapy (TF-CBT) have demonstrated efficacy for youth with posttraumatic stress disorder, TF-CBT effectiveness trials typically show attenuated outcomes. This decrease in effectiveness may be due to the differences in sociodemographic characteristics of youth in these trials; youth in efficacy trials are more often white and middle-income, whereas youth in effectiveness trials are more often racial/ethnic minorities, of low socioeconomic status (SES) and live in high crime neighborhoods. In this study-drawn from an effectiveness trial of TF-CBT in community mental health clinics across Philadelphia-we describe the sociodemographic characteristics of enrolled youth. We measured neighborhood SES by matching participants' addresses to American Community Survey data from their Census tracts, housing stability using the National Outcomes Measurement System, and neighborhood violence using police department crime statistics. Our results suggest that the majority of youth presenting for TF-CBT in mental health clinics in the City of Philadelphia live in poor and high-crime neighborhoods, experience substantial housing instability, and are predominantly ethnic and racial minorities. Thus, youth presenting for treatment experience significant racial and socioeconomic adversity. We also explored the association between these characteristics and youth symptom severity upon presenting for treatment. These factors were not associated with youth symptom severity or overall mental health functioning in our sample (with small effect sizes and p > .05 for all). Implications for future research, such as the need for efficacy and effectiveness trials to more fully characterize their samples and the need for pragmatic trials are discussed.
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Affiliation(s)
- Briana S. Last
- Department of Psychology, School of Arts and Sciences, The University of Pennsylvania
| | - Brittany N. Rudd
- Department of Psychiatry, Perelman School of Medicine, The University of Pennsylvania
| | - Courtney A. Gregor
- Department of Psychiatry, Perelman School of Medicine, The University of Pennsylvania
| | | | | | | | | | | | | | | | - Rinad S. Beidas
- Department of Psychiatry, Perelman School of Medicine, The University of Pennsylvania
- Medical Ethics and Health Policy, University of Pennsylvania Perelman School of Medicine
- Penn Implementation Science Center at the Leonard Davis Institute of Health Economics (PISCE@LDI), University of Pennsylvania
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Mendelson T, Clary LK, Sibinga E, Tandon D, Musci R, Mmari K, Salkever D, Stuart EA, Ialongo N. A randomized controlled trial of a trauma-informed school prevention program for urban youth: Rationale, design, and methods. Contemp Clin Trials 2020; 90:105895. [PMID: 31786150 PMCID: PMC8100974 DOI: 10.1016/j.cct.2019.105895] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2019] [Revised: 11/12/2019] [Accepted: 11/14/2019] [Indexed: 11/28/2022]
Abstract
INTRODUCTION Youth in disadvantaged urban areas are frequently exposed to chronic stress and trauma, including housing instability, neighborhood violence, and other poverty-related adversities. These exposures increase risk for emotional, behavioral, and academic problems and ultimately, school dropout. Schools are a promising setting in which to address these issues; however, there are few universal, trauma-informed school-based interventions for urban youth. METHODS/DESIGN Project POWER (Promoting Options for Wellness and Emotion Regulation) is a randomized controlled trial testing the impact of RAP Club, a trauma-informed intervention for eighth graders that includes mindfulness as a core component. Students in 32 urban public schools (n = 800) are randomly assigned to either RAP Club or a health education active control group. We assess student emotional, behavioral, and academic outcomes using self-report surveys and teacher ratings at baseline, post-intervention, and 4-month follow up. Focus groups and interviews with students, teachers, and principals address program feasibility, acceptability, and fidelity, as well as perceived program impacts. Students complete an additional self-report survey in ninth grade. Schools provide students' academic and disciplinary data for their seventh, eighth, and ninth grade years. In addition, data on program costs are collected to conduct an economic analysis of the intervention and active control programs. DISCUSSION Notable study features include program co-leadership by young adults from the community and building capacity of school personnel for continued program delivery. In addition to testing program impact, we will identify factors related to successful program implementation to inform future program use and dissemination.
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Affiliation(s)
- Tamar Mendelson
- Johns Hopkins Bloomberg School of Public Health, United States.
| | - Laura K Clary
- Johns Hopkins Bloomberg School of Public Health, United States
| | - Erica Sibinga
- Johns Hopkins Bloomberg School of Public Health, United States
| | | | - Rashelle Musci
- Johns Hopkins Bloomberg School of Public Health, United States
| | - Kristin Mmari
- Johns Hopkins Bloomberg School of Public Health, United States
| | - David Salkever
- Johns Hopkins Bloomberg School of Public Health, United States
| | | | - Nick Ialongo
- Johns Hopkins Bloomberg School of Public Health, United States
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26
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Cloitre M, Hyland P, Bisson JI, Brewin CR, Roberts NP, Karatzias T, Shevlin M. ICD-11 Posttraumatic Stress Disorder and Complex Posttraumatic Stress Disorder in the United States: A Population-Based Study. J Trauma Stress 2019; 32:833-842. [PMID: 31800131 DOI: 10.1002/jts.22454] [Citation(s) in RCA: 130] [Impact Index Per Article: 26.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2018] [Revised: 03/13/2019] [Accepted: 03/29/2019] [Indexed: 12/24/2022]
Abstract
The primary aim of this study was to provide an assessment of the current prevalence rates of International Classification of Diseases (11th rev.) posttraumatic stress disorder (PTSD) and complex PTSD (CPTSD) among the adult population of the United States and to identify characteristics and correlates associated with each disorder. A total of 7.2% of the sample met criteria for either PTSD or CPTSD, and the prevalence rates were 3.4% for PTSD and 3.8% for CPTSD. Women were more likely than men to meet criteria for both PTSD and CPTSD. Cumulative adulthood trauma was associated with both PTSD and CPTSD; however, cumulative childhood trauma was more strongly associated with CPTSD than PTSD. Among traumatic stressors occurring in childhood, sexual and physical abuse by caregivers were identified as events associated with risk for CPTSD, whereas sexual assault by noncaregivers and abduction were risk factors for PTSD. Adverse childhood events were associated with both PTSD and CPTSD, and equally so. Individuals with CPTSD reported substantially higher psychiatric burden and lower levels of psychological well-being compared to those with PTSD and those with neither diagnosis.
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Affiliation(s)
- Marylène Cloitre
- National Center for PTSD Dissemination and Training Division, VA Palo Alto Health Care System, Palo Alto, California, USA.,Department of Psychiatry and Behavioural Sciences, Stanford University, Stanford, California, USA
| | - Philip Hyland
- Department of Psychology, Maynooth University, Kildare, Ireland.,Centre for Global Health, Trinity College Dublin, Dublin, Ireland
| | - Jonathan I Bisson
- Division of Psychological Medicine and Clinical Neurosciences, School of Medicine, Cardiff University, Cardiff, United Kingdom
| | - Chris R Brewin
- Clinical Educational and Health Psychology, University College-London, London, United Kingdom
| | - Neil P Roberts
- Psychology and Psychological Therapies Directorate, Cardiff and Vale University Health Board, Cardiff, United Kingdom.,Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, United Kingdom
| | - Thanos Karatzias
- National Health Service Lothian, Rivers Centre for Traumatic Stress, Edinburgh, United Kingdom.,School of Health and Social Care, Edinburgh Napier University, Edinburgh, United Kingdom
| | - Mark Shevlin
- School of Psychology, Ulster University, Derry, Northern Ireland
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State-of-the-Science Review of Non-Chemical Stressors Found in a Child's Social Environment. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16224417. [PMID: 31718056 PMCID: PMC6888402 DOI: 10.3390/ijerph16224417] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/21/2019] [Revised: 11/07/2019] [Accepted: 11/08/2019] [Indexed: 12/14/2022]
Abstract
Background: Children are exposed to chemical and non-chemical stressors from their built, natural, and social environments. Research is needed to advance our scientific understanding of non-chemical stressors, evaluate how they alter the biological response to a chemical stressor, and determine how they impact children’s health and well-being. To do this, we conducted a state-of-the-science review of non-chemical stressors found in a child’s social environment. Methods: Studies eligible for inclusion in this review were identified through a search of the peer-reviewed literature using PubMed and PsycINFO. Combinations of words associated with non-chemical stressors and children were used to form search strings. Filters were used to limit the search to studies published in peer-reviewed journals from 2000–2016 and written in English. Publications found using the search strings and filters went through two rounds of screening. Results: A total of 146 studies met the inclusion criteria. From these studies, 245 non-chemical stressors were evaluated. The non-chemical stressors were then organized into 13 general topic areas: acculturation, adverse childhood experiences, economic, education, family dynamics, food, greenspace, neighborhood, social, stress, urbanicity, violence, and other. Additional information on health outcomes, studies evaluating both chemical and non-chemical stressors, and animal studies are provided. This review provides evidence that non-chemical stressors found in a child’s social environment do influence their health and well-being in both beneficial (e.g., salutatory effects of greenspace and social support) and adverse (e.g., poor relationships between health and selected non-chemical stressors such as economics, educational attainment, exposure to violence, stress) ways. Conclusions: This literature review identified a paucity of studies addressing the combined effects of chemical and non-chemical stressors and children’s health and well-being. This literature review was further complicated by inconsistencies in terminology, methodologies, and the value of non-chemical stressor research in different scientific disciplines. Despite these limitations, this review showed the importance of considering non-chemical stressors from a child’s social environment when addressing children’s environmental health considerations.
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Lambert HK, McLaughlin KA. Impaired hippocampus-dependent associative learning as a mechanism underlying PTSD: A meta-analysis. Neurosci Biobehav Rev 2019; 107:729-749. [PMID: 31545990 DOI: 10.1016/j.neubiorev.2019.09.024] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2019] [Revised: 08/10/2019] [Accepted: 09/13/2019] [Indexed: 12/19/2022]
Abstract
Smaller hippocampal volume is associated with increased risk for PTSD following trauma, but the hippocampal functions involved remain unknown. We propose a conceptual model that identifies broad impairment in hippocampus-dependent associative learning as a vulnerability factor for PTSD. Associative learning of foreground cues and background context is required to form an integrated representation of an event. People with poor associative learning may have difficulty remembering who or what was present during a trauma, where the trauma occurred, or the sequence of events, which may contribute to PTSD symptoms. We argue that associative learning difficulties in PTSD exist for cues and context, regardless of the emotional nature of the information. This contrasts with PTSD models that focus exclusively on threat-processing or contextual-processing. In a meta-analysis, people with PTSD exhibited poor associative learning of multiple information types compared to those without PTSD. Differences were of medium effect size and similar magnitude for neutral and negative/trauma-related stimuli. We provide evidence for associative learning difficulties as a neurocognitive pathway that may contribute to PTSD.
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Affiliation(s)
- Hilary K Lambert
- Department of Psychology, University of Washington, 119A Guthrie Hall, Box 351525, Seattle, WA, 98195-1525, USA.
| | - Katie A McLaughlin
- Department of Psychology, Harvard University, William James Hall, 33 Kirkland Street, Cambridge, MA 02138, USA.
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29
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Bremer-Landau JD, Caskie GIL. Gender as Potential Moderator of Associations Among Trauma Exposure, Posttraumatic Stress Disorder Symptoms, and Alcohol Use Disorder Symptoms in Young Adults. J Trauma Stress 2019; 32:586-594. [PMID: 31291486 DOI: 10.1002/jts.22419] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2018] [Revised: 01/19/2019] [Accepted: 01/30/2019] [Indexed: 11/11/2022]
Abstract
Traumatic events (TEs), posttraumatic stress disorder (PTSD) symptoms, and alcohol use disorder (AUD) symptoms can significantly impair functioning, yet little is known about whether associations among these variables differ between men and women within young adult samples. The current study conducted a path analysis of archival, longitudinal data from the Drug Use Trajectories: Ethnic/Racial Comparisons 1998-2002 (DUT) study (Turner, 2011) to examine gender differences as a possible moderator of the relations between TEs, PTSD symptoms, and AUD symptoms among 1,076 young adults (aged 18-23 years) residing in South Florida. The sample included 580 male (53.9%) and 496 female (46.1%) participants, whose ethnicity was self-reported as African American (n = 280, 26.0%), non-Hispanic White (n = 268, 24.9%), other Hispanic (n = 267, 24.8%), and Cuban (n = 261, 24.3%). Significant positive associations were found between TEs and PTSD symptoms, βs = .08-.30; PTSD and AUD symptoms, βs = .09 - .10; PTSD symptoms over time, β = .52; and AUD symptoms over time, β = .46. In addition, for male but not female participants, a higher frequency of PTSD symptoms at Wave I was related to more AUD symptoms at Wave II, β = .09. Findings build upon existing research to further elucidate the role of gender as a potential moderator of the associations among TEs, PTSD symptoms, and AUD symptoms for young adults and provide important implications for future research and clinical practice, including informing mental health prevention and treatment efforts.
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Affiliation(s)
- Jodi D Bremer-Landau
- Department of Education and Human Services, Lehigh University, Bethlehem, Pennsylvania, USA
| | - Grace I L Caskie
- Department of Education and Human Services, Lehigh University, Bethlehem, Pennsylvania, USA
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Kerns CM, Berkowitz SJ, Moskowitz LJ, Drahota A, Lerner MD, Newschaffer CJ. Screening and treatment of trauma-related symptoms in youth with autism spectrum disorder among community providers in the United States. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2019; 24:515-525. [PMID: 31200605 DOI: 10.1177/1362361319847908] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Using a cross-sectional survey of 673 multidisciplinary autism spectrum disorder providers recruited from five different sites in the United States, we examined the frequency with which community-based providers inquire about, screen, and treat trauma-related symptoms in their patients/students and assessed their perceptions regarding the need for and barriers to providing these services. Univariate and bivariate frequencies of self-reported trauma service provision, training needs, and barriers were estimated. Multivariable logistic regressions identified provider and patient-related factors associated with trauma-related symptoms screening and treatment. Over 50% of providers reported some screening and treatment of trauma-related symptoms in youth with autism spectrum disorder. Over 70% informally inquired about trauma-related symptoms; only 10% universally screened. Screening and treatment varied by provider discipline, setting, amount of interaction, and years of experience with autism spectrum disorder, as well as by patient/student sex, ethnicity, and socioeconomic status. Most providers agreed that trauma screening is a needed service impeded by inadequate provider training in trauma identification and treatment. The findings indicate that community providers in the United States of varied disciplines are assessing and treating trauma-related symptoms in youth with autism spectrum disorder, and that evidence-based approaches are needed to inform and maximize these efforts.
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Zerach G, Elklit A. Attachment and social support mediate associations between Polyvictimization and psychological distress in early adolescence. INTERNATIONAL JOURNAL OF PSYCHOLOGY 2019; 55:380-391. [PMID: 31134627 DOI: 10.1002/ijop.12590] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2018] [Accepted: 04/28/2019] [Indexed: 11/11/2022]
Abstract
The current study assesses associations between multiple experience of traumatic events (polyvictimization), PTSD symptoms (PTSS) and psychiatric symptoms in early adolescence, and explores the mediating roles of attachment orientations and perceived social support in the associations between polyvictimization, PTSS and psychiatric symptoms. In 2001, a representative national sample of 390 Danish eighth-graders (M = 13.95, SD = .37) completed validated self-report questionnaires. Polyvictimization was related to higher PTSS and psychiatric symptoms. Importantly, polyvictimization was significantly linked to high attachment anxiety, which was linked with low perceived social support, which in turn was linked with high PTSS levels and psychiatric symptoms. Polyvictimization might have dire consequences in early adolescence. An individual's high attachment anxiety might be connected with lack of perceived social support, which should be seen as a possible psychological distress mechanism subsequent to exposure to a number of potentially traumatic events.
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Affiliation(s)
- Gadi Zerach
- Department of Behavioral Sciences, Ariel University, Ariel, Israel
| | - Ask Elklit
- National Center of Psychotraumatology, Institute of Psychology, University of Southern Denmark, Odense, Denmark
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32
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Samara M, El Asam A, Khadaroo A, Hammuda S. Examining the psychological well-being of refugee children and the role of friendship and bullying. BRITISH JOURNAL OF EDUCATIONAL PSYCHOLOGY 2019; 90:301-329. [PMID: 31056751 DOI: 10.1111/bjep.12282] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2018] [Revised: 03/18/2019] [Indexed: 01/07/2023]
Abstract
BACKGROUND Refugee children might have experienced violent and traumatic events before settling into a new country. In the United Kingdom, the number of refugee children is increasing; however, little is known about their psycho-social and physical well-being. AIM This study aims to investigate the psychological well-being and behaviour of refugee children compared to British-born children on a number of psychological, social, behavioural, and health-related issues and to investigate the role of friendship as a protective factor. SAMPLES This study utilized a sample of 149 refugee children recruited from two charities, 79 of which are children aged 6-10 years and 70 older refugee children aged 11-16 years. The study also included 120 non-refugee children recruited from primary schools aged 6-10 years. METHODS This is a cross-sectional study that investigates the psycho-social well-being of refugee children compared to non-refugee British-born children. The study explored symptoms of posttraumatic stress disorder, emotional and behavioural problems (Strengths and Difficulties Questionnaire), self-esteem, friendships and popularity, bullying and victimization, physical health, and psychosomatic problems. RESULTS Young refugee children reported more peer problems, functional impairment, physical health, and psychosomatic problems compared to the control children and older refugee children groups. On the other hand, older refugee children had lower self-esteem (academic and social self-peers) compared to the younger refugee children group. The differences between the groups were explained by friendship quality, number of friends, peer bullying/victimization, or sibling bullying/victimization except for physical health and psychosomatic problems. CONCLUSIONS While refugee children were found to be at risk on various levels, the findings also point to the fact that social relationships including friendship quality and number of friends played an essential protective role. Conversely, bullying was a risk factor that explained many of the refugees' problems. These findings pave the way for future research to further probe into the well-being of refugee children in the United Kingdom while also targeting relevant intervention schemes specifically tailored to address their needs.
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Affiliation(s)
- Muthanna Samara
- Department of Psychology, Kingston University London, Kingston upon Thames, UK
| | - Aiman El Asam
- Department of Psychology, Kingston University London, Kingston upon Thames, UK
| | | | - Sara Hammuda
- Department of Psychology, Kingston University London, Kingston upon Thames, UK
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Weber M, Alvariza A, Kreicbergs U, Sveen J. Communication in families with minor children following the loss of a parent to cancer. Eur J Oncol Nurs 2019; 39:41-46. [DOI: 10.1016/j.ejon.2019.01.005] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2018] [Revised: 09/12/2018] [Accepted: 01/19/2019] [Indexed: 11/16/2022]
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Subjective traumatic outlook as a screening tool for psychological trauma: Cut-off values and diagnostic criteria. Psychiatry Res 2019; 273:121-126. [PMID: 30641341 DOI: 10.1016/j.psychres.2019.01.014] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2018] [Revised: 12/18/2018] [Accepted: 01/03/2019] [Indexed: 11/27/2022]
Abstract
The Subjective Traumatic Outlook (STO) deals with changes in individuals' perception, following a traumatic event and the difficulties of integrating pre-trauma past memories, inner traumatic memories, and current daily life. Although this short scale has excellent psychometric properties its cut-off scores for potential clinical use have yet to be established. In addition, due to the discrepancy between the Diagnostic and Statistical Manual of Mental Disorders (DSM) and the International Classification of Diseases (ICD) in the meaurement of post-traumatic stress disorder (PTSD), the present study aimed at revalidating the STO and establishing cut-off scores for potential clinical use, based on both approaches to measure PTSD and complex post-traumatic stress disorder (CPTSD). Three hundred forty-three adults who were recruited through social media apps filled in self-report online questionnaires dealing with subjective perception of psychological trauma, PTSD and CPTSD. Results revalidate the STO as a screening tool for PTSD and CPTSD. We recommend a STO cut-off score of 13 and above when using the ICD-11 PTSD proposed algorithm along the PCL-5 cutoff score and a STO cut-off score of 15 when using the ICD-11 CPTSD proposed algorithm. In light of the present findings, the integration of DSM and ICD approaches is discussed.
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Lewis SJ, Arseneault L, Caspi A, Fisher HL, Matthews T, Moffitt TE, Odgers CL, Stahl D, Teng JY, Danese A. The epidemiology of trauma and post-traumatic stress disorder in a representative cohort of young people in England and Wales. Lancet Psychiatry 2019; 6:247-256. [PMID: 30798897 PMCID: PMC6384243 DOI: 10.1016/s2215-0366(19)30031-8] [Citation(s) in RCA: 190] [Impact Index Per Article: 38.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2018] [Revised: 12/17/2018] [Accepted: 12/21/2018] [Indexed: 12/15/2022]
Abstract
BACKGROUND Despite the emphasis placed on childhood trauma in psychiatry, comparatively little is known about the epidemiology of trauma and trauma-related psychopathology in young people. We therefore aimed to evaluate the prevalence, clinical features, and risk factors associated with trauma exposure and post-traumatic stress disorder (PTSD) in young people. METHODS We carried out a comprehensive epidemiological study based on participants from the Environmental Risk Longitudinal Twin Study, a population-representative birth-cohort of 2232 children born in England and Wales in 1994-95. At the follow-up home visit at age 18 years, participants were assessed with structured interviews for trauma exposure, PTSD, other psychopathology, risk events, functional impairment, and service use. Risk factors for PTSD were measured prospectively over four previous assessments between age 5 and 12 years. The key outcomes were the prevalence, clinical features, and risk factors associated with trauma exposure and PTSD. We also derived and tested the internal validity of a PTSD risk calculator. FINDINGS We found that 642 (31·1%) of 2064 participants reported trauma exposure and 160 (7·8%) of 2063 experienced PTSD by age 18 years. Trauma-exposed participants had high rates of psychopathology (187 [29·2%] of 641 for major depressive episode, 146 [22·9%] of 638 for conduct disorder, and 102 [15·9%] of 641 for alcohol dependence), risk events (160 [25·0%] of 641 for self-harm, 53 [8·3%] of 640 for suicide attempt, and 42 [6·6%] of 640 for violent offence), and functional impairment. Participants with lifetime PTSD had even higher rates of psychopathology (87 [54·7%] of 159 for major depressive episode, 43 [27·0%] of 159 for conduct disorder, and 41 [25·6%] of 160 for alcohol dependence), risk events (78 [48·8%] of 160 for self-harm, 32 [20·1%] of 159 for suicide attempt, and 19 [11·9%] of 159 for violent offence), and functional impairment. However, only 33 (20·6%) of 160 participants with PTSD received help from mental health professionals. The PTSD risk calculator had an internally validated area under the receiver operating characteristic curve of 0·74, indicating adequate discrimination of trauma-exposed participants with and without PTSD, and internally validated calibration-in-the-large of -0·10 and calibration slope of 0·90, indicating adequate calibration. INTERPRETATION Trauma exposure and PTSD are associated with complex psychiatric presentations, high risk, and significant impairment in young people. Improved screening, reduced barriers to care provision, and comprehensive clinical assessment are needed to ensure that trauma-exposed young people and those with PTSD receive appropriate treatment. FUNDING The Medical Research Council, the National Institute of Child Health and Development, the Jacobs Foundation, the Nuffield Foundation, the National Society for Prevention of Cruelty to Children, the Economic and Social Research Council, the National Institute for Health Research, MQ, and Canadian Institutes for Advanced Research.
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Affiliation(s)
- Stephanie J Lewis
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK; Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Louise Arseneault
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Avshalom Caspi
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK; Department of Psychology and Neuroscience and Department of Psychiatry and Behavioral Sciences, Duke University, Durham, NC, USA
| | - Helen L Fisher
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Timothy Matthews
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Terrie E Moffitt
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK; Department of Psychology and Neuroscience and Department of Psychiatry and Behavioral Sciences, Duke University, Durham, NC, USA
| | - Candice L Odgers
- Department of Psychology and Social Behavior, University of California, Irvine, CA, USA
| | - Daniel Stahl
- Department of Biostatistics, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Jia Ying Teng
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK; Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Andrea Danese
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK; Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK; National and Specialist CAMHS Clinic for Trauma, Anxiety, and Depression, South London and Maudsley NHS Foundation Trust, London, UK.
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Henderson Z. In Their Own Words: How Black Teens Define Trauma. JOURNAL OF CHILD & ADOLESCENT TRAUMA 2019; 12:141-151. [PMID: 32318187 PMCID: PMC7163812 DOI: 10.1007/s40653-017-0168-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Trauma is a subjective phenomenon. However, when examining trauma among low-income, Black teens, it is common to use established clinical criteria as the metric for identifying and evaluating its presence and impact. Little attention has been devoted to exploring how Black youth characterize trauma in their own terms. This qualitative study explored the concept of trauma from the perspectives of 12 low-income, Black teens. Participants' descriptions included death and loss; violence exposure; police harassment, racism, and discrimination; poverty; being stuck in the hood; and being bullied. While some of their descriptions were compatible with traumatic stressors outlined in the Diagnostic and Statistical Manual of Mental Disorders (DSM), participants also highlighted factors that are not explicitly enumerated in the DSM. Findings present important implications for the development of more culturally and developmentally inclusive discussions of trauma and for clinical practice with low-income, Black youth who are impacted by trauma and adversity.
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Affiliation(s)
- Zuleka Henderson
- Department of Social Work, Bowie State University, 14000 Jericho Park Road, Bowie, MD 20715 USA
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Fang S, Chung MC. The impact of past trauma on psychological distress among Chinese students: The roles of cognitive distortion and alexithymia. Psychiatry Res 2019; 271:136-143. [PMID: 30472509 DOI: 10.1016/j.psychres.2018.11.032] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2018] [Revised: 11/15/2018] [Accepted: 11/15/2018] [Indexed: 11/26/2022]
Abstract
Past traumatic events are distressing experiences which can result in the emergence of posttraumatic stress disorders (PTSD) and other psychological symptoms among university students. However, little is known as to whether or not cognitive distortion and alexithymia would influence the severity of these distress outcomes. This study examined a cognitive-emotional framework depicting potential roles that cognitive distortion and alexithymia could play in influencing the relationship between past trauma and psychiatric co-morbidities among university students in China. One thousand one hundred and eleven participants completed the PTSD Checklist for DSM-5, Cognitive Distortion Scale (CDS), Toronto Alexithymia Scale (TAS-20), and General Health Questionnaire (GHQ-28). Results indicated that PTSD following past trauma was significantly associated with increased psychiatric co-morbidities after controlling for covariates. Both alexithymia and distorted cognition mediated the association between PTSD and psychiatric co-morbidities. To conclude, university students can develop PTSD from past trauma and other mental health problems. The severity of psychological distress can be influenced by their distorted perceptions of themselves, the world, and the future, as well as their ability to identify, describe, and express distressing emotions.
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Affiliation(s)
- Siqi Fang
- Department of Educational Psychology, Faculty of Education, The Chinese University of Hong Kong, Shatin, N.T., Hong Kong, People's Repulic of China.
| | - Man Cheung Chung
- Department of Educational Psychology, Faculty of Education, The Chinese University of Hong Kong, Shatin, N.T., Hong Kong, People's Repulic of China.
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Gruebner O, Rapp MA, Adli M, Kluge U, Galea S, Heinz A. Cities and Mental Health. DEUTSCHES ARZTEBLATT INTERNATIONAL 2018; 114:121-127. [PMID: 28302261 DOI: 10.3238/arztebl.2017.0121] [Citation(s) in RCA: 111] [Impact Index Per Article: 18.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/19/2016] [Revised: 07/19/2016] [Accepted: 01/11/2017] [Indexed: 11/27/2022]
Abstract
BACKGROUND More than half of the global population currently lives in cities, with an increasing trend for further urbanization. Living in cities is associated with increased population density, traffic noise and pollution, but also with better access to health care and other commodities. METHODS This review is based on a selective literature search, providing an overview of the risk factors for mental illness in urban centers. RESULTS Studies have shown that the risk for serious mental illness is generally higher in cities compared to rural areas. Epidemiological studies have associated growing up and living in cities with a considerably higher risk for schizophrenia. However, correlation is not causation and living in poverty can both contribute to and result from impairments associated with poor mental health. Social isolation and discrimination as well as poverty in the neighborhood contribute to the mental health burden while little is known about specific interactions between such factors and the built environment. CONCLUSION Further insights on the interaction between spatial heterogeneity of neighborhood resources and socio-ecological factors is warranted and requires interdisciplinary research.
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Affiliation(s)
- Oliver Gruebner
- Department of Epidemiology and Health Monitoring of the Robert Koch Institute, Berlin; Social and Preventive Medicine, Universität Potsdam; Department of Psychiatry and Psychotherapy, Charité Universitätsmedizin, Berlin; School of Public Health, Boston University, MA, USA; Berlin Institute for Integration and Migration Research (BIM), Humboldt University of Berlin
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Ionio C, Camisasca E, Milani L, Miragoli S, Di Blasio P. Facing Death in Adolescence: What Leads to Internalization and Externalization Problems? JOURNAL OF CHILD & ADOLESCENT TRAUMA 2018; 11:367-373. [PMID: 32318162 PMCID: PMC7163872 DOI: 10.1007/s40653-017-0166-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
The aim of this study was to test a model to better explain which factors are linked to the development of internalized and externalized problems in adolescents experiencing death through structural equation model. Internalizing problems were predicted by low self-esteem, high PTSD symptomatology and by being a female, whereas externalizing problems were predicted by low self-esteem, by the experience of the loss as central in their own life and by being a male. Our results pointed out the potential importance of controlling this factors in order to provide focused interventions for adolescents after the death of a significant one.
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Affiliation(s)
- Chiara Ionio
- CRIdee, Department of Psychology, Università Cattolica, Largo Gemelli, 1, 20123 Milano, Italy
| | | | - Luca Milani
- CRIdee, Department of Psychology, Università Cattolica, Largo Gemelli, 1, 20123 Milano, Italy
| | - Sarah Miragoli
- CRIdee, Department of Psychology, Università Cattolica, Largo Gemelli, 1, 20123 Milano, Italy
| | - Paola Di Blasio
- CRIdee, Department of Psychology, Università Cattolica, Largo Gemelli, 1, 20123 Milano, Italy
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The influence of deployment stress and life stress on Post-Traumatic Stress Disorder (PTSD) diagnosis among military personnel. J Psychiatr Res 2018; 103:26-32. [PMID: 29772483 DOI: 10.1016/j.jpsychires.2018.05.005] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2017] [Revised: 04/27/2018] [Accepted: 05/07/2018] [Indexed: 11/21/2022]
Abstract
There is increasing recognition that traumatic stress encountered throughout life, including those prior to military service, can put individuals at increased risk for developing Posttraumatic Stress Disorder (PTSD). The purpose of this study was to examine the association of both traumatic stress encountered during deployment, and traumatic stress over one's lifetime on probable PTSD diagnosis. Probable PTSD diagnosis was compared between military personnel deployed in Operation Iraqi Freedom/Operation Enduring Freedom (OIF/OEF; N = 21,499) and those who have recently enlisted (N = 55,814), using data obtained from the Army Study to Assess Risk and Resilience in Servicemembers (Army STARRS). Probable PTSD diagnosis was assessed using the PTSD Checklist. The effect of exposure to multiple types (i.e. diversity) of traumatic stress and the total quantity (i.e. cumulative) of traumatic stress on probable PTSD diagnosis was also compared. Military personnel who had been deployed experienced higher rates of PTSD symptoms than new soldiers. Diversity of lifetime traumatic stress predicted probable PTSD diagnosis in both groups, whereas cumulative lifetime traumatic stress only predicted probable PTSD for those who had been deployed. For deployed soldiers, having been exposed to various types of traumatic stress during deployment predicted probable PTSD diagnosis, but cumulative deployment-related traumatic stress did not. Similarly, the total quantity of traumatic stress (i.e. cumulative lifetime traumatic stress) did not predict probable PTSD diagnosis among new soldiers. Together, traumatic stress over one's lifetime is a predictor of probable PTSD for veterans, as much as traumatic stress encountered during war. Clinicians treating military personnel with PTSD should be aware of the impact of traumatic stress beyond what occurs during war.
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Kaplow JB, Layne CM, Oosterhoff B, Goldenthal H, Howell KH, Wamser-Nanney R, Burnside A, Calhoun K, Marbury D, Johnson-Hughes L, Kriesel M, Staine MB, Mankin M, Porter-Howard L, Pynoos R. Validation of the Persistent Complex Bereavement Disorder (PCBD) Checklist: A Developmentally Informed Assessment Tool for Bereaved Youth. J Trauma Stress 2018; 31:244-254. [PMID: 29669184 PMCID: PMC5922782 DOI: 10.1002/jts.22277] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2017] [Revised: 12/17/2017] [Accepted: 01/05/2018] [Indexed: 11/08/2022]
Abstract
The inclusion of Persistent Complex Bereavement Disorder (PCBD) in the DSM-5 appendix signifies a call for research regarding the distinguishing features and clinical utility of proposed PCBD criteria. Rigorously constructed tools for assessing PCBD are lacking, especially for youth. This study evaluated the validity and clinical utility of the PCBD Checklist, a 39-item measure designed to assess PCBD criteria in youth aged 8 to18 years. Test construction procedures involved: (a) reviewing the literature regarding developmental manifestations of proposed criteria, (b) creating a developmentally informed item pool, (c) surveying an expert panel to evaluate the clarity and developmental appropriateness of candidate items, (d) conducting focus groups to evaluate the comprehensibility and acceptability of items, and (e) evaluating psychometric properties in 367 bereaved youth (Mage = 13.49, 55.0% female). The panel, clinicians, and youth provided favorable content validity and comprehensibility ratings for candidate items. As hypothesized, youth who met full PCBD criteria, Criterion B (e.g., preoccupation with the deceased and/or circumstances of the death), or Criterion C (e.g., reactive distress and/or social/identity disruption) reported higher posttraumatic stress and depressive symptoms than youth who did not meet these criteria, ηp2 = .07-.16. Youth who met Criterion C reported greater functional impairment than youth who did not, ηp2 = .08-.12. Youth who qualified for the "traumatic bereavement specifier" reported more frequent posttraumatic stress symptoms than youth who did not, ηp2 = .04. Findings support the convergent, discriminant, and discriminant-groups validity, developmental appropriateness, and clinical utility of the PCBD Checklist.
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Affiliation(s)
- Julie B. Kaplow
- Department of Pediatrics, Baylor College of Medicine/Texas Children’s Hospital, Houston, Texas, USA
| | - Christopher M. Layne
- Department of Psychiatry, University of California, Los Angeles, California, USA
| | - Benjamin Oosterhoff
- Department of Pediatrics, Baylor College of Medicine/Texas Children’s Hospital, Houston, Texas, USA
| | - Hayley Goldenthal
- Department of Psychology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Kathryn H. Howell
- Department of Psychiatry, University of Memphis, Memphis, Tennessee, USA
| | - Rachel Wamser-Nanney
- Department of Psychological Sciences, University of Missouri-St. Louis, Missouri, USA
| | - Amanda Burnside
- Department of Psychology, Loyola University, Chicago, Illinois, USA
| | - Karen Calhoun
- Michigan Institute for Clinical and Health Research, University of Michigan, Ann Arbor, Michigan, USA
| | - Daphne Marbury
- St. John Providence Health System, Detroit, Michigan, USA
| | | | | | | | | | | | - Robert Pynoos
- Department of Pediatrics, Baylor College of Medicine/Texas Children’s Hospital, Houston, Texas, USA
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Usta MB, Gumus YY, Say GN, Bozkurt A, Şahin B, Karabekiroğlu K. Basal blood DHEA-S/cortisol levels predicts EMDR treatment response in adolescents with PTSD. Nord J Psychiatry 2018; 72:164-172. [PMID: 29171317 DOI: 10.1080/08039488.2017.1406984] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
OBJECTIVE In literature, recent evidence has shown that the hypothalamic-pituitary-adrenal (HPA) axis can be dysregulated in patients with post-traumatic stress disorder (PTSD) and HPA axis hormones may predict the psychotherapy treatment response in patients with PTSD. In this study, it was aimed to investigate changing cortisol and DHEA-S levels post-eye movement desensitization and reprocessing (EMDR) therapy and the relationship between treatment response and basal cortisol, and DHEA-S levels before treatment. METHOD The study group comprised 40 adolescents (age, 12-18 years) with PTSD. The PTSD symptoms were assessed using the Child Depression Inventory (CDI) and Child Post-traumatic Stress Reaction Index (CPSRI) and the blood cortisol and DHEA-S were measured with the chemiluminescence method before and after treatment. A maximum of six sessions of EMDR therapy were conducted by an EMDR level-1 trained child psychiatry resident. Treatment response was measured by the pre- to post-treatment decrease in self-reported and clinical PTSD severity. RESULTS Pre- and post-treatment DHEA-S and cortisol levels did not show any statistically significant difference. Pre-treatment CDI scores were negatively correlated with pre-treatment DHEA-S levels (r: -0.39). ROC analysis demonstrated that the DHEA-S/cortisol ratio predicts treatment response at a medium level (AUC: 0.703, p: .030, sensitivity: 0.65, specificity: 0.86). CONCLUSION The results of this study suggested that the DHEA-S/cortisol ratio may predict treatment response in adolescents with PTSD receiving EMDR therapy. The biochemical parameter of HPA-axis activity appears to be an important predictor of positive clinical response in adolescent PTSD patients, and could be used in clinical practice to predict PTSD treatment in the future.
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Affiliation(s)
- Mirac Baris Usta
- a Department of Child and Adolescent Psychiatry, School of Medicine , Ondokuz Mayıs University , Samsun , Turkey
| | - Yusuf Yasin Gumus
- a Department of Child and Adolescent Psychiatry, School of Medicine , Ondokuz Mayıs University , Samsun , Turkey
| | - Gokce Nur Say
- a Department of Child and Adolescent Psychiatry, School of Medicine , Ondokuz Mayıs University , Samsun , Turkey
| | - Abdullah Bozkurt
- a Department of Child and Adolescent Psychiatry, School of Medicine , Ondokuz Mayıs University , Samsun , Turkey
| | - Berkan Şahin
- a Department of Child and Adolescent Psychiatry, School of Medicine , Ondokuz Mayıs University , Samsun , Turkey
| | - Koray Karabekiroğlu
- a Department of Child and Adolescent Psychiatry, School of Medicine , Ondokuz Mayıs University , Samsun , Turkey
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Faye C, McGowan JC, Denny CA, David DJ. Neurobiological Mechanisms of Stress Resilience and Implications for the Aged Population. Curr Neuropharmacol 2018; 16:234-270. [PMID: 28820053 PMCID: PMC5843978 DOI: 10.2174/1570159x15666170818095105] [Citation(s) in RCA: 59] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2017] [Revised: 06/25/2017] [Accepted: 07/27/2017] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Stress is a common reaction to an environmental adversity, but a dysregulation of the stress response can lead to psychiatric illnesses such as major depressive disorder (MDD), post-traumatic stress disorder (PTSD), and anxiety disorders. Yet, not all individuals exposed to stress will develop psychiatric disorders; those with enhanced stress resilience mechanisms have the ability to adapt successfully to stress without developing persistent psychopathology. Notably, the potential to enhance stress resilience in at-risk populations may prevent the onset of stress-induced psychiatric disorders. This novel idea has prompted a number of studies probing the mechanisms of stress resilience and how it can be manipulated. METHODS Here, we review the neurobiological factors underlying stress resilience, with particular focus on the serotoninergic (5-HT), glutamatergic, and γ-Aminobutyric acid (GABA) systems, as well as the hypothalamic-pituitary axis (HPA) in rodents and in humans. Finally, we discuss stress resiliency in the context of aging, as the likelihood of mood disorders increases in older adults. RESULTS Interestingly, increased resiliency has been shown to slow aging and improved overall health and quality of life. Research in the neurobiology of stress resilience, particularly throughout the aging process, is a nascent, yet, burgeoning field. CONCLUSION Overall, we consider the possible methods that may be used to induce resilient phenotypes, prophylactically in at-risk populations, such as in military personnel or in older MDD patients. Research in the mechanisms of stress resilience may not only elucidate novel targets for antidepressant treatments, but also provide novel insight about how to prevent these debilitating disorders from developing.
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Affiliation(s)
- Charlène Faye
- CESP/UMR-S 1178, Univ. Paris-Sud, Fac Pharmacie, Inserm, Université Paris-Saclay, 92296 Chatenay-Malabry, France
| | - Josephine C. McGowan
- Doctoral Program in Neurobiology and Behavior, Columbia University, New York, NY, USA
| | - Christine A. Denny
- Department of Psychiatry, Columbia University, New York, NY, USA
- Division of Integrative Neuroscience, New York State Psychiatric Institute/Research Foundation for Mental Hygiene, Inc., New York, NY, USA
| | - Denis J. David
- CESP/UMR-S 1178, Univ. Paris-Sud, Fac Pharmacie, Inserm, Université Paris-Saclay, 92296 Chatenay-Malabry, France
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McCutcheon VV, Agrawal A, Kuo SIC, Su J, Dick DM, Meyers JL, Edenberg HJ, Nurnberger JI, Kramer JR, Kuperman S, Schuckit MA, Hesselbrock VM, Brooks A, Porjesz B, Bucholz KK. Associations of parental alcohol use disorders and parental separation with offspring initiation of alcohol, cigarette and cannabis use and sexual debut in high-risk families. Addiction 2018; 113:336-345. [PMID: 28804966 PMCID: PMC5760304 DOI: 10.1111/add.14003] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2017] [Revised: 05/04/2017] [Accepted: 08/04/2017] [Indexed: 02/03/2023]
Abstract
BACKGROUND AND AIMS Parental alcohol use disorders (AUDs) and parental separation are associated with increased risk for early use of alcohol in offspring, but whether they increase risks for early use of other substances and for early sexual debut is under-studied. We focused on associations of parental AUDs and parental separation with substance initiation and sexual debut to (1) test the strength of the associations of parental AUDs and parental separation with time to initiation (age in years) of alcohol, tobacco and cannabis use and sexual debut and (2) compare the strength of association of parental AUD and parental separation with initiation. DESIGN Prospective adolescent and young adult cohort of a high-risk family study, the Collaborative Study on the Genetics of Alcoholism (COGA). SETTING Six sites in the United States. PARTICIPANTS A total of 3257 offspring (aged 14-33 years) first assessed in 2004 and sought for interview approximately every 2 years thereafter; 1945 (59.7%) offspring had a parent with an AUD. MEASUREMENTS Diagnostic interview data on offspring substance use and sexual debut were based on first report of these experiences. Parental life-time AUD was based on their own self-report when parents were interviewed (1991-2005) for most parents, or on offspring and other family member reports for parents who were not interviewed. Parental separation was based on offspring reports of not living with both biological parents most of the time between ages 12 and 17 years. FINDINGS Parental AUDs were associated with increased hazards for all outcomes, with cumulative hazards ranging from 1.19 to 2.71. Parental separation was also an independent and consistent predictor of early substance use and sexual debut, with hazards ranging from 1.19 to 2.34. The strength of association of parental separation with substance initiation was equal to that of having two AUD-affected parents, and its association with sexual debut was stronger than the association of parental AUD in one or both parents. CONCLUSIONS Parental alcohol use disorders (AUDs) and parental separation are independent and consistent predictors of increased risk for early alcohol, tobacco and cannabis use and sexual debut in offspring from families with a high risk of parental AUDs.
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Affiliation(s)
| | - Arpana Agrawal
- Washington University School of Medicine, St. Louis, MO, USA
| | | | - Jinni Su
- Virginia Commonwealth University, Richmond, VA, USA
| | | | | | | | | | - John R. Kramer
- University of Iowa Carver College of Medicine, Iowa City, IA USA
| | - Samuel Kuperman
- University of Iowa Carver College of Medicine, Iowa City, IA USA
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Mahat-Shamir M, Ring L, Hamama-Raz Y, Ben-Ezra M, Pitcho-Prelorentzos S, David UY, Zaken A, Lavenda O. Do previous experience and geographic proximity matter? Possible predictors for diagnosing Adjustment disorder vs. PTSD. Psychiatry Res 2017; 258:438-443. [PMID: 28951140 DOI: 10.1016/j.psychres.2017.08.085] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2017] [Revised: 08/06/2017] [Accepted: 08/29/2017] [Indexed: 02/05/2023]
Abstract
The minority of people who have experienced a traumatic event and were diagnosed as either suffering from PTSD or from Adjustment disorder, may suggest that victims of a traumatic event vary in risk factors for the disorders. The current research aimed at examining the association between reports of Adjustment disorder and PTSD symptoms (In accordance with the proposed revisions of the ICD-11) and several vulnerability variables: previous traumatic event, previous stressful event and physical proximity to the terror attack. Using an online survey, 379 adult participants were recruited, and filled out Adjustment disorder, PTSD symptomatology scales, as well as a previous exposure, magnitude of exposure and death anxiety scales. Findings revealed that previous experience of traumatic events was a significant predictor associated with both PTSD and Adjustment disorder symptoms. Previous experience of stressful events was a significant predictor associated with Adjustment disorder alone. Physical proximity to the site of the attack was a significant predictor associated with PTSD symptoms but not Adjustment disorder symptoms. The importance of previous traumatic events, previous stressful events and physical proximity to the terror attack as factors which are associated with Adjustment disorder and PTSD symptomatology is discussed.
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Affiliation(s)
| | - Lia Ring
- School of Social Work, Ariel University, Israel
| | | | | | | | - Udi Y David
- School of Social Work, Ariel University, Israel
| | - Adi Zaken
- School of Social Work, Ariel University, Israel
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Cadichon JM, Lignier B, Cénat JM, Derivois D. Symptoms of PTSD Among Adolescents and Young Adult Survivors Six Years after the 2010 Haiti Earthquake. JOURNAL OF LOSS & TRAUMA 2017. [DOI: 10.1080/15325024.2017.1360585] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
| | - Baptiste Lignier
- Laboratoire Psy-DREPI, University of Bourgogne Franche-Comté, Dijon, France
| | - Jude-Mary Cénat
- Department of Sexology, University of Quebec, Montreal, Canada
| | - Daniel Derivois
- Laboratoire Psy-DREPI, University of Bourgogne Franche-Comté, Dijon, France
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Hart SR, Van Eck K, Ballard ED, Musci RJ, Newcomer A, Wilcox HC. Subtypes of suicide attempters based on longitudinal childhood profiles of co-occurring depressive, anxious and aggressive behavior symptoms. Psychiatry Res 2017; 257:150-155. [PMID: 28755606 DOI: 10.1016/j.psychres.2017.07.032] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2017] [Revised: 06/03/2017] [Accepted: 07/16/2017] [Indexed: 01/14/2023]
Abstract
Because suicide attempts are multi-determined events, multiple pathways to suicidal behaviors exist. However, as a low-frequency behavior, within group differences in trajectories to attempts may not emerge when examined in samples including non-attempters. We used longitudinal latent profile analysis to identify subtypes specific for suicide attempters based on longitudinal trajectories of childhood clinical symptoms (i.e., depression, anxiety, and aggression measured in 2nd, 4th-7th grades) for 161 young adults (35.6% male; 58.6% African American) who attempted suicide between ages 13-30 from a large, urban community-based, longitudinal prevention trial (n = 2311). Differences in psychiatric diagnoses, suicide attempt characteristics, criminal history and traumatic stress history were studied. Three subtypes emerged: those with all low (n = 32%), all high (n = 16%), and high depressive/anxious, but low aggressive (n = 52%) symptoms. Those with the highest levels of all symptoms were significantly more likely to report a younger age of suicide attempt, and demonstrate more substance abuse disorders and violent criminal histories. Prior studies have found that childhood symptoms of depression, anxiety and aggression are malleable targets; interventions directed at each reduce future risk for suicidal behaviors. Our findings highlight the link of childhood aggression with future suicidal behaviors extending this research by examining childhood symptoms of aggression in the context of depression and anxiety.
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Affiliation(s)
- Shelley R Hart
- Department of Child Development, California State University, Chico, CA, USA; Department of Mental Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA
| | - Kathryn Van Eck
- Department of Mental Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA; Department of Pediatrics, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - Elizabeth D Ballard
- Experimental Therapeutics & Pathophysiology Branch, National Institute of Mental Health, Bethesda, MD, USA
| | - Rashelle J Musci
- Department of Mental Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA
| | - Alison Newcomer
- Psychology Department, The Catholic University of America, Washington DC, USA
| | - Holly C Wilcox
- Department of Mental Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA; Division of Child and Adolescent Psychiatry, Johns Hopkins School of Medicine, Baltimore, MD, USA.
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Barboza GE, Dominguez S, Pinder J. Trajectories of post-traumatic stress and externalizing psychopathology among maltreated foster care youth: A parallel process latent growth curve model. CHILD ABUSE & NEGLECT 2017; 72:370-382. [PMID: 28917187 DOI: 10.1016/j.chiabu.2017.09.007] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/29/2016] [Revised: 09/05/2017] [Accepted: 09/07/2017] [Indexed: 06/07/2023]
Abstract
Few longitudinal studies have analyzed how violence exposure (e.g. child maltreatment, witnessing community violence) influence both externalizing and Post-Traumatic Stress (PTS) symptoms among children in foster care. Data from three waves of the National Survey of Child and Adolescent Well-Being (1999-2007) (NSCAW; National Data Archive on Child Abuse and Neglect, 2002) were analyzed to investigate the change trajectories of both externalizing and PTS symptomatology among children with a substantiated report of child maltreatment by Child Protective Services (CPS) between October 1999 and December 2000. This study uses data collected at three time points: baseline and approximately 18 (Wave 3) and 36 (Wave 4) months post-baseline. The Child Behavior Checklist (CBCL) scale measured externalizing symptoms and the Post Traumatic Stress Disorder section of a version of the Trauma Symptom Checklist for Children (TSCC) provided the measure of current trauma-related symptoms or distress. Analyses were conducted using a parallel process growth curve model with a sample of n=280 maltreated youth between the ages of 8 and 15 following home removal. Findings revealed that initial levels of externalizing and PTS symptomatology were both significantly and positively related and co-develop over time. Externalizing symptom severity remained in the borderline range during the first two years in out-of-home care. Both direct and indirect forms of interpersonal violence exposure were associated with initial level of externalizing symptom and PTS symptom severity, respectively. Taken together, our results suggest an underlying process that links early violence exposure to the co-development and cumulative impact of PTS on externalizing behavior above and beyond experiences of maltreatment. We conclude by discussing the key points of intervention that result from a more nuanced understanding of the longitudinal relationship between PTS and externalizing symptoms and the effect of complex trauma on growth in these symptoms over time.
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Affiliation(s)
- Gia Elise Barboza
- Northeastern University, College of Social Science and Humanities, 212 Renaissance Park, Boston, MA 02115, United States.
| | - Silvia Dominguez
- Northeastern University, College of Social Science and Humanities, 212 Renaissance Park, Boston, MA 02115, United States.
| | - Jyda Pinder
- Northeastern University, College of Social Science and Humanities, 212 Renaissance Park, Boston, MA 02115, United States.
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López CM, Andrews AR, Chisolm AM, de Arellano MA, Saunders B, Kilpatrick DG. Racial/ethnic differences in trauma exposure and mental health disorders in adolescents. CULTURAL DIVERSITY & ETHNIC MINORITY PSYCHOLOGY 2017; 23:382-387. [PMID: 27786496 PMCID: PMC5408300 DOI: 10.1037/cdp0000126] [Citation(s) in RCA: 53] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
OBJECTIVE Research has cited increased prevalence of mood disorders, anxiety disorders, and exposure to interpersonal violence for Hispanics and non-Hispanic Black adolescents, as well as ethnic differences in externalizing behavior (e.g., substance use, delinquency). The current study combined these areas by examining racial/ethnic differences in mental health correlates of trauma exposure. METHOD Interviews were conducted to assess polyvictimization, posttraumatic stress disorder (PTSD), major depressive disorder (MDD), substance use, and delinquency in a nationally representative sample of adolescents (N = 3,614; 15.4% non-Hispanic Black; 11.3% Hispanic; 64.9% non-Hispanic White). RESULTS Hispanic and non-Hispanic Black adolescents endorsed greater polyvictimization than non-Hispanic Whites; however, differences in MDD and PTSD were only significant when assessed with symptom counts. Non-Hispanic Black adolescents reported the least drug use. Non-Hispanic Black and Hispanic adolescents endorsed more delinquency than non-Hispanic White adolescents. Polyvictimization only accounted for ethnic disparities in delinquency. CONCLUSION Trauma-related disparities may differ across internalizing and externalizing concerns. Subsequent research should continue to examine other factors that may contribute to racial/ethnic differences in trauma sequelae. (PsycINFO Database Record
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Acuña MA, Kataoka S. Family Communication Styles and Resilience among Adolescents. SOCIAL WORK 2017; 62:261-269. [PMID: 28449105 DOI: 10.1093/sw/swx017] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/29/2016] [Accepted: 12/13/2016] [Indexed: 05/07/2023]
Abstract
Some adolescents manage to be resilient, whereas others develop posttraumatic stress disorder (PTSD) symptoms after experiencing trauma, but the mechanisms underlying these differences are unclear. Public secondary school students (N = 98) referred for counseling completed questionnaires assessing exposure to stressful events, family communication, and PTSD. Seventy percent of the sample reported PTSD symptoms in the clinical range. Open family communication was negatively associated with female gender, problem family communication (PFC), and PTSD symptom severity. PFC was positively associated with female gender, number of stressful events, and PTSD symptom severity. Family storytelling style had a negative association with age, PFC, and avoidance symptoms. In the full regression model only the number of life events and PFC appeared to have an independent effect on PTSD symptom severity. Results indicate that exposure to stressful life events and poor family communication are associated with increased risk for PTSD symptoms. Findings may be useful in family-focused approaches to treating adolescents with trauma histories and highlighting the importance of PTSD screening in school-based counseling.
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Affiliation(s)
| | - Sheryl Kataoka
- Center for Health Services and Society, Division of Child and Adolescent Psychiatry, University of California, Los Angeles
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