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Ahmadi F, Goodarzi MA, Taghavi MR, Imani M. Modeling the structural relationships between trauma exposure with substance use tendency, depression symptoms, and suicidal thoughts in individuals with earthquake trauma experience: the mediatory role of peritraumatic dissociation and experiential avoidance. BMC Psychiatry 2024; 24:171. [PMID: 38429677 PMCID: PMC10905816 DOI: 10.1186/s12888-024-05595-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2023] [Accepted: 02/06/2024] [Indexed: 03/03/2024] Open
Abstract
BACKGROUND Despite the fact that studies indicate that earthquake trauma is associated with numerous psychological consequences, the mediating mechanisms leading to these outcomes have not been well-studied. Therefore, this study investigates the relationship between trauma exposure with substance use tendency, depression, and suicidal thoughts, with the mediating role of peritraumatic dissociation and experiential avoidance. METHODS The descriptive-correlational approach was employed in this study. The participants were people who had experienced the Kermanshah earthquake in 2017. A total of 324 people were selected by convenient sampling method. The Traumatic Exposure Severity Scale, the Peritraumatic Dissociative Experiences Questionnaire, the Acceptance and Action Questionnaire, the Iranian Addiction Potential Scale, Beck's Depression Inventory [BDI-II], and Beck's Suicidal Thoughts Scale were used to collect data. The gathered data was analyzed using structural equation modeling in SPSS Ver. 24 and LISREL Ver. 24. RESULTS The study findings indicated that the intensity of the trauma exposure is directly and significantly associated with depression symptoms, peritraumatic dissociation, and experiential avoidance. The severity of exposure to trauma had a significant indirect effect on the tendency to use substances through experiential avoidance. This is while the severity of the trauma experience did not directly correlate with substance use and suicidal thoughts. In addition, peritraumatic dissociation did not act as a mediator in the relationship between the severity of trauma exposure with substance use, depression, and suicidal thoughts. CONCLUSIONS The severity of exposure to the earthquake was associated with symptoms of depression and these findings indicate the importance of experiential avoidance in predicting the tendency to use drugs. Hence, it is essential to design and implement psychological interventions that target experiential avoidance to prevent drug use tendencies and to establish policies that lower depression symptoms following natural disasters.
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Affiliation(s)
- Farshad Ahmadi
- Department of Clinical Psychology, Faculty of Educational Sciences and Psychology, University of Shiraz, Shiraz, Iran.
| | - Mohammad Ali Goodarzi
- Department of Clinical Psychology, Faculty of Educational Sciences and Psychology, University of Shiraz, Shiraz, Iran
| | - Mohammad Reza Taghavi
- Department of Clinical Psychology, Faculty of Educational Sciences and Psychology, University of Shiraz, Shiraz, Iran
| | - Mahdi Imani
- Department of Clinical Psychology, Faculty of Educational Sciences and Psychology, University of Shiraz, Shiraz, Iran
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Alpay EH, Aydın A. Effects of peritraumatic reactions on post-traumatic stress among Kahramanmaras earthquake survivors. Nord J Psychiatry 2024; 78:153-161. [PMID: 38165775 DOI: 10.1080/08039488.2023.2291548] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Accepted: 12/01/2023] [Indexed: 01/04/2024]
Abstract
PURPOSE Peritraumatic reactions play a crucial role in the development of mental health problems, including depression and post-traumatic stress disorder. Therefore, this study sought to examine the influence of the peritraumatic reactions, including peritraumatic dissociation, peritraumatic distress, mental defeat, and tonic immobility, on post-traumatic stress disorder and major depressive disorder in earthquake survivors. MATERIALS AND METHODS A total of 261 adult participants aged between 18 and 65 (Mage=29.20, SD = 28.06, 162 were female, and 99 were male) who were exposed to the Kahramanmaras earthquake in February 2023 were recruited in the study. Data were collected between April 10 and 18 2023, two months after the earthquake. Participants completed questionnaires, including The International Trauma Questionnaire, The International Depression Questionnaire, The Mental Defeat Questionnaire, The Tonic Immobility Scale, and The Peritraumatic Dissociative Experiences Questionnaire. RESULTS Two-step multiple linear regression analyses indicated all peritraumatic reactions predicted both post-traumatic stress disorder and depression. Dominance analysis results showed that the contribution of peritraumatic dissociation in predicting PTSD and depression was higher among other peritraumatic reactions. CONCLUSION The findings of the study revealed a robust association between peritraumatic reactions and both depression and PTSD, shedding light on the underlying processes in the development of trauma-related disorders. Early assessment of peritraumatic reactions may be useful in identifying individuals at risk of developing PTSD and depression.
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Affiliation(s)
- Emre H Alpay
- Department of Psychology, Mersin University, Mersin, Türkiye
| | - Arzu Aydın
- Department of Psychology, Mersin University, Mersin, Türkiye
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Soffer-Dudek N. Obsessive-compulsive symptoms and dissociative experiences: Suggested underlying mechanisms and implications for science and practice. Front Psychol 2023; 14:1132800. [PMID: 37051604 PMCID: PMC10084853 DOI: 10.3389/fpsyg.2023.1132800] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2022] [Accepted: 03/03/2023] [Indexed: 03/29/2023] Open
Abstract
A strong and specific link between obsessive-compulsive disorder or symptoms (OCD/S) and a tendency for dissociative experiences (e.g., depersonalization-derealization, absorption and imaginative involvement) cannot be explained by trauma and is poorly understood. The present theoretical formulation proposes five different models conceptualizing the relationship. According to Model 1, dissociative experiences result from OCD/S through inward-focused attention and repetition. According to Model 2, dissociative absorption causally brings about both OCD/S and associated cognitive risk factors, such as thought-action fusion, partly through impoverished sense of agency. The remaining models highlight common underlying causal mechanisms: temporo-parietal abnormalities impairing embodiment and sensory integration (Model 3); sleep alterations causing sleepiness and dreamlike thought or mixed sleep-wake states (Model 4); and a hyperactive, intrusive imagery system with a tendency for pictorial thinking (Model 5). The latter model relates to Maladaptive Daydreaming, a suggested dissociative syndrome with strong ties to the obsessive-compulsive spectrum. These five models point to potential directions for future research, as these theoretical accounts may aid the two fields in interacting with each other, to the benefit of both. Finally, several dissociation-informed paths for further developing clinical intervention in OCD are identified.
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Affiliation(s)
- Nirit Soffer-Dudek
- The Consciousness and Psychopathology Laboratory, Department of Psychology, Ben-Gurion University of the Negev, Be’er Sheva, Israel
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deMello RAF, Coimbra BM, Pedro BDM, Benvenutti IM, Yeh MSL, Mello AF, Mello MF, Poyares DR. Peri-Traumatic Dissociation and Tonic Immobility as Severity Predictors of Posttraumatic Stress Disorder After Rape. JOURNAL OF INTERPERSONAL VIOLENCE 2023; 38:4240-4266. [PMID: 35899768 DOI: 10.1177/08862605221114151] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Some individuals show abnormal reactions to extreme fear and life-threatening situations, including tonic immobility (TI) and peri-traumatic dissociation (PTD). We aimed to investigate the association of TI and PTD with posttraumatic stress disorder (PTSD) in women who experienced sexual violence and the risk factors for PTD occurrence. We compared PTSD severity in 86 young adult women with PTSD after a sexual violence exposure grouped according to the presence of PTD and TI. In addition, we investigated whether PTD is associated with depression and anxiety symptoms and assessed potential risk factors for PTD reaction. We found a significant positive correlation between PTSD severity and PTD occurrence (R2 = .132; p = .001). PTD was also positively correlated with all clusters of PTSD symptoms except the Clinician-Administered PTSD Scale avoidance cluster (p = .058). PTD was strongly correlated with anxiety (R2 = .619; p < .001) and depressive symptoms (R2 = .547; p < .001). Multiple logistic regression showed that history of physical abuse (odds ratio [OR]: 1.386; p = .011) and sexual abuse (OR: 1.947; p = .004) during childhood were associated with PTD occurrence. Other risk factors for PTD were having less years of study (OR: 0.216; p = .016) and lower income (OR: 7.403; p = .028). TI measures were available for a subsample of 29 women. We found no association between TI and PTSD severity. PTD, but not TI, is significantly associated with more severe PTSD, depressive, and anxiety symptoms. Less-educated women with a history of childhood abuse and a lower income are at risk of PTD occurrence during a sexual violence episode.
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Affiliation(s)
- Ricardo A F deMello
- Faculdade Israelita de Ciências da Saúde Albert Einstein, Instituto Israelita de Ensino e Pesquisa, Hospital Israelita Albert Einstein, São Paulo, Brazil
| | - Bruno Messina Coimbra
- Program for Research and Care on Violence and PTSD (PROVE), Department of Psychiatry, Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil
- Amsterdam UMC, location University of Amsterdam, Department of Psychiatry, Amsterdam Public Health Research Institute and Amsterdam Neuroscience Research Institute, Amsterdam, The Netherlands
| | - Bianca D M Pedro
- Faculdade Israelita de Ciências da Saúde Albert Einstein, Instituto Israelita de Ensino e Pesquisa, Hospital Israelita Albert Einstein, São Paulo, Brazil
| | - Isabella M Benvenutti
- Faculdade Israelita de Ciências da Saúde Albert Einstein, Instituto Israelita de Ensino e Pesquisa, Hospital Israelita Albert Einstein, São Paulo, Brazil
| | - Mary S L Yeh
- Program for Research and Care on Violence and PTSD (PROVE), Department of Psychiatry, Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil
| | - Andrea F Mello
- Faculdade Israelita de Ciências da Saúde Albert Einstein, Instituto Israelita de Ensino e Pesquisa, Hospital Israelita Albert Einstein, São Paulo, Brazil
- Program for Research and Care on Violence and PTSD (PROVE), Department of Psychiatry, Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil
| | - Marcelo F Mello
- Faculdade Israelita de Ciências da Saúde Albert Einstein, Instituto Israelita de Ensino e Pesquisa, Hospital Israelita Albert Einstein, São Paulo, Brazil
- Program for Research and Care on Violence and PTSD (PROVE), Department of Psychiatry, Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil
| | - Dalva R Poyares
- Department of Psychobiology, Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil
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Attrash-Najjar A, Katz C. "Not understanding but feeling guilty at the same time": The peritraumatic responses of CSA survivors from the Muslim Arab community in Israel. CHILD ABUSE & NEGLECT 2022; 134:105945. [PMID: 36356425 DOI: 10.1016/j.chiabu.2022.105945] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Revised: 10/19/2022] [Accepted: 10/30/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND Studies on child sexual abuse (CSA) have greatly contributed to theoretical and empirical developments, advancing policy and practice. However, studies on CSA in closed societies are still scarce. OBJECTIVE The current study focuses on CSA in the Muslim Arab community in Israel while delving into the peritraumatic responses of survivors to CSA. PARTICIPANTS AND SETTING Twenty-eight Muslim Arab survivors of CSA provided written testimonies for an independent inquiry. METHODS The exploration of the Muslim Arab survivors' peritraumatic responses to CSA, according to their testimonies, was guided by an inductive thematic analysis and Braun and Clarke's (2006) six steps of analysis. RESULTS The results indicated that, as most of the abusive incidents were committed by an extended family member, the survivors experienced an inability to understand what had happened to them while simultaneously feeling guilt and self-blame. Furthermore, the survivors discussed feeling trapped by all of the systems and social expectations in their lives, leaving them feeling extremely lonely and with the understanding that seeking help and disclosing the abuse was not relevant for them. CONCLUSION The discussion addresses the developments in the research on peritraumatic responses that require further examination. This includes top-down processes that might explain survivors' peritraumatic responses, which are not merely instinctual. In addition, when perpetrators are family members, survivors are expected to stay in contact with them, which demands enormous resources and survival strategies from the survivors.
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Affiliation(s)
| | - Carmit Katz
- Bob Shapell School of Social Work, Tel Aviv University, Israel.
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Mangold A, King AR, Herting NA. The Role of Children's PTSD Symptomatology in Non-Offending Caregivers' Secondary Traumatic Stress Symptomatology Following Disclosures of Sexual or Physical Abuse. JOURNAL OF CHILD & ADOLESCENT TRAUMA 2022; 15:553-565. [PMID: 35958711 PMCID: PMC9360266 DOI: 10.1007/s40653-021-00408-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 09/16/2021] [Indexed: 06/15/2023]
Abstract
This research examined factors influencing levels of secondary traumatic stress (STS) in non-offending caregivers (NOCs) of children with histories of sexual or physical abuse. These factors included the nature of the abuse, NOCs' relationships with the initiators of the abuse, children's ages and genders, NOCs' trauma histories, and the elapsed time between children's disclosures of abuse and their trauma assessments. As a secondary objective, this research examined the interactions between children's self-reports of their own posttraumatic stress disorder (PTSD) symptomatology, NOCs' estimates of their children's PTSD symptomatology, and NOCs' self-reports of their own STS symptomatology. Participants from a clinical sample (N = 300, children = 150, NOCs = 150; child age M = 9.89, SD = 4.08; NOC age M = 37.87, SD = 9.23) completed structured intake interviews, the PTSD Checklist for the DSM-5 (PCL-5) and the Child PTSD Symptom Scale (CPSS; Child-Report and NOC-Report). Analytic strategies included point-biserial correlation coefficient calculations, linear regression analyses, and Analyses of Covariance (ANCOVAs). NOCs' levels of STS were impacted by their relationships with the initiators of the abuse and their own trauma histories. NOCs' self-reported STS symptomatology mirrored their estimates of their children's PTSD symptomatology. The discrepancy scores between children's self-reports of their PTSD symptomatology and NOCs' estimates of children's PTSD symptomatology were impacted by children's ages and genders. Clinical practitioners should note the importance of examining children's PTSD symptomatology and NOCs' STS symptomatology concurrently when making recommendations for trauma-informed evidence-based treatments.
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Affiliation(s)
- Ani Mangold
- Department of Psychological Sciences, University of North Dakota, Grand Forks, ND USA
- Red River Children’s Advocacy Center, Fargo, ND USA
| | - Alan R. King
- Department of Psychological Sciences, University of North Dakota, Grand Forks, ND USA
| | - Nicola A. Herting
- Department of Psychological Sciences, University of North Dakota, Grand Forks, ND USA
- Red River Children’s Advocacy Center, Fargo, ND USA
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Zara G, Settanni M, Zuffranieri M, Veggi S, Castelli L. The long psychological shadow of COVID-19 upon healthcare workers: A global concern for action. J Affect Disord 2021; 294:220-226. [PMID: 34303300 PMCID: PMC8433601 DOI: 10.1016/j.jad.2021.07.056] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Revised: 06/08/2021] [Accepted: 07/10/2021] [Indexed: 01/21/2023]
Abstract
INTRODUCTION The outbreak of COVID-19 has posed unprecedented psychological pressure upon every National Health Service in the world. In Piedmont, one of the most affected areas in Italy, 4550 healthcare workers were assessed online in May-June 2020, after the acute outbreak of March-April 2020, that compelled the Italian government to enforce, what was then, the first total lockdown in the Western world. METHODS Socio-demographic information of healthcare workers was gathered along with responses to: General Anxiety Disorder-7, Impact of Event Scale-Revised, Beck Depression Inventory-II, Peritraumatic Dissociative Experiences Questionnaire. Information about the need for psychological support was also gathered. RESULTS The regression models predicted the presence of moderate to severe symptoms for all the conditions assessed. Almost half of healthcare workers presented at least one clinically relevant symptom, and among them one in every four expressed the need of receiving psychological support. CONCLUSIONS Evidence calls for an increase of psychological services within the National Health System in Italy so as to guarantee for healthcare workers the psychological support necessary to cope with the long shadow of COVID-19, whose long-term impact is likely to reveal itself more strongly the more the acute stage of it is passed. LIMITATIONS The assessment of the psychological symptoms was performed without knowing the life and professional situations of the sample, and their medical records. Healthcare workers from only one region in Italy were involved, and some professionals (e.g. self-employed healthcare workers) were not included.
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Affiliation(s)
- Georgia Zara
- Department of Psychology, University of Turin, Italy.
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Kindermann D, Sanzenbacher M, Nagy E, Greinacher A, Cranz A, Nikendei A, Friederich HC, Nikendei C. Prevalence and risk factors of secondary traumatic stress in emergency call-takers and dispatchers - a cross-sectional study. Eur J Psychotraumatol 2020; 11:1799478. [PMID: 33062208 PMCID: PMC7534265 DOI: 10.1080/20008198.2020.1799478] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
Background: Emergency call-takers and dispatchers (ECDs) field emergency calls and dispatch the appropriate emergency services. Exposure to the callers' traumatic experiences can lead to psychological stress and even to secondary traumatic stress (STS). In addition, previous studies suggest that ECDs may also suffer from posttraumatic stress disorder (PTSD), depression and anxiety disorders. Objectives: To investigate the prevalence of STS and to screen for PTSD, depression and anxiety disorders in ECDs. We further aimed to identify sociodemographic variables and attachment styles as possible risk factors for higher STS symptom load in ECDs. Methods: STS and PTSD regarding lifetime traumatic events, as well as depression and anxiety disorders, were investigated in N = 71 ECDs. Multiple regression analysis was performed to identify possible risk factors for higher STS symptom load. Results: The analysis determined a prevalence of 8.5% for moderate STS and 2.8% for severe STS. A total of 11.3% of the ECDs screened positive for PTSD, 15.5% for depression and 7.0% for anxiety disorders. A higher number of children and the absence of a secure attachment style were identified to be significantly associated with higher STS symptom load. Conclusions: STS resulting from exposure to traumatic emergency caller content is a common phenomenon among ECDs. Specific sociodemographic variables and the attachment style are significant risk factors of STS symptom load. ECDs should receive regular psychoeducational interventions and supervision to identify and mitigate mental distress at an early stage.
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Affiliation(s)
- David Kindermann
- Department of General Internal Medicine and Psychosomatics, University Hospital Heidelberg, University of Heidelberg, Heidelberg, Germany
| | - Monique Sanzenbacher
- Department of General Internal Medicine and Psychosomatics, University Hospital Heidelberg, University of Heidelberg, Heidelberg, Germany
| | - Ede Nagy
- Department of General Internal Medicine and Psychosomatics, University Hospital Heidelberg, University of Heidelberg, Heidelberg, Germany
| | - Anja Greinacher
- Department of General Internal Medicine and Psychosomatics, University Hospital Heidelberg, University of Heidelberg, Heidelberg, Germany
| | - Anna Cranz
- Department of General Internal Medicine and Psychosomatics, University Hospital Heidelberg, University of Heidelberg, Heidelberg, Germany
| | - Alexander Nikendei
- German Red Cross, Rescue Service Bodensee-Oberschwaben, Ravensburg, Germany
| | - Hans-Christoph Friederich
- Department of General Internal Medicine and Psychosomatics, University Hospital Heidelberg, University of Heidelberg, Heidelberg, Germany
| | - Christoph Nikendei
- Department of General Internal Medicine and Psychosomatics, University Hospital Heidelberg, University of Heidelberg, Heidelberg, Germany
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Hardiness and Coping Strategies as Mediators of Stress and Secondary Trauma in Emergency Workers during the COVID-19 Pandemic. SUSTAINABILITY 2020. [DOI: 10.3390/su12187561] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
The work environment of emergency workers is an important factor related to stress. Coping with the COVID-19 emergency is a factor that is highly related to stress, and severe stress is a risk factor for developing secondary trauma. Coping and resilience can help rescue workers to better respond in emergency situations and could protect them from secondary trauma. We aimed to explore the relationship of emergency stress, hardiness, coping strategies, and secondary trauma among emergency workers and the mediating roles of coping strategies and hardiness on the effect of stress in producing secondary trauma. The study involved 513 emergency workers from the Red Cross Committee in Veneto, one of the Italian regions most affected by the COVID-19. Participants completed questionnaires online to measure emergency stress (physical, emotional, cognitive, organizational‒relational, COVID-19, and inefficacy decisional), hardiness, coping strategies, and secondary trauma. Other variables analyzed were age, gender, weekly hours of service, and use of personal protective equipment (PPE). We performed t-tests, a correlational analysis, regressions, and a mediation analysis. Hardiness and coping strategies, in particular, which stop unpleasant emotions and thoughts and problem-focused, emerged as mediators in reducing the predicted effect of stress on secondary trauma. The mediating effects of hardiness and coping strategies were found to reduce the effect of stress on arousal by 15% and the effect on avoidance by 25%.
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Opie E, Brooks S, Greenberg N, Rubin GJ. The usefulness of pre-employment and pre-deployment psychological screening for disaster relief workers: a systematic review. BMC Psychiatry 2020; 20:211. [PMID: 32393208 PMCID: PMC7216600 DOI: 10.1186/s12888-020-02593-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2019] [Accepted: 04/12/2020] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND Individuals who conduct disaster relief work overseas are exposed to a variety of traumatic events that can cause distress and trigger psychological illnesses. Identification of which disaster relief workers may be at risk of experiencing psychological distress or mental health disorders is frequently carried out through pre-employment or pre-deployment psychological screening. The primary objective of our review was to assess the evidence for pre-employment and pre-deployment psychological screening of relief workers who work in disaster situations. We aimed to identify specific pre-employment and pre-deployment characteristics that predict impaired wellbeing of an individual following engaging in disaster-related work. METHODS A combined list of search terms was composed relating to disaster-related occupations, screening methods, psychological disorders, and study design. The databases used were PsycINFO, MEDLINE, EMBASE, and GlobalHealth. We included studies that used cross-sectional or longitudinal study designs; were published in the English language in peer-reviewed academic journals; reported on the association between pre-employment and pre-deployment features and post-deployment psychological disorders or distress; considered any occupational groups responding to a specified, discrete crisis; and used at least one validated measure of distress or disorder. We extracted data on the author; year of publication; disaster description; country of study; study design; population sample; disorder(s) outcome and the measures used; and results. RESULTS Sixty-two, high-quality studies were included in the review. Forty-one potential predictors were identified. Of these, only volunteer status and previous history of mental illness and life stressors emerged as reliable predictors of distress or disorder. CONCLUSION The results suggest that whilst it is attractive to screen for pre-employment and pre-deployment indicators of resilience, the evidence base for doing so is weak. At best, this sort of screening can only weakly suggest vulnerability and at worst may result in discrimination. Until better evidence about its usefulness becomes available, employers should exercise caution over its use.
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Affiliation(s)
- Elena Opie
- NIHR Health Protection Research Unit in Emergency Preparedness and Response, King's College London, Weston Education Centre, Cutcombe Rd, London, SE5 9RJ, UK.
| | - Samantha Brooks
- grid.13097.3c0000 0001 2322 6764NIHR Health Protection Research Unit in Emergency Preparedness and Response, King’s College London, Weston Education Centre, Cutcombe Rd, London, SE5 9RJ UK
| | - Neil Greenberg
- grid.13097.3c0000 0001 2322 6764NIHR Health Protection Research Unit in Emergency Preparedness and Response, King’s College London, Weston Education Centre, Cutcombe Rd, London, SE5 9RJ UK
| | - G. James Rubin
- grid.13097.3c0000 0001 2322 6764NIHR Health Protection Research Unit in Emergency Preparedness and Response, King’s College London, Weston Education Centre, Cutcombe Rd, London, SE5 9RJ UK
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Birmes P, Brunet A, Benoit M, Defer S, Hatton L, Sztulman H, Schmitt L. Validation of the Peritraumatic Dissociative Experiences Questionnaire self-report version in two samples of French-speaking individuals exposed to trauma. Eur Psychiatry 2020; 20:145-51. [PMID: 15797699 DOI: 10.1016/j.eurpsy.2004.06.033] [Citation(s) in RCA: 96] [Impact Index Per Article: 24.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2003] [Accepted: 06/21/2004] [Indexed: 11/16/2022] Open
Abstract
AbstractBackgroundPeritraumatic dissociation is a risk factor for developing PTSD. The Peritraumatic Dissociative Experiences Questionnaire (PDEQ) is a self-report inventory used to assess dissociation that occurred at the time of a trauma. The aim of this study was the validation the PDEQ in French.MethodsNinety French speaking traumatized victims presenting to the emergency department were recruited. They were administered the PDEQ shortly after exposure and others trauma-related measures 2 weeks and 1 month posttrauma.ResultsPrincipal components factor analyses suggested a single factor solution for the PDEQ. Significant correlations between the PDEQ and acute and posttraumatic stress symptoms indicated moderate to strong convergent validity. The PDEQ also showed satisfactory test–retest reliability and internal consistency.ConclusionsThis study is the first one to investigate such detailed psychometric findings on the PDEQ. This confirms the unity of the concept of peritraumatic dissociation and the value of the PDEQ-French Version to assess it.
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Affiliation(s)
- Philippe Birmes
- Department of Psychiatry and Douglas Hospital Research Center, Psychosocial Research Division, McGill University, Montreal, Que. Canada.
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Allen M, Handy J, Miller D, Servatius R. Avoidance learning and classical eyeblink conditioning as model systems to explore a learning diathesis model of PTSD. Neurosci Biobehav Rev 2019; 100:370-386. [DOI: 10.1016/j.neubiorev.2019.03.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2018] [Revised: 03/04/2019] [Accepted: 03/05/2019] [Indexed: 01/09/2023]
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Allen MT, Myers CE, Beck KD, Pang KCH, Servatius RJ. Inhibited Personality Temperaments Translated Through Enhanced Avoidance and Associative Learning Increase Vulnerability for PTSD. Front Psychol 2019; 10:496. [PMID: 30967806 PMCID: PMC6440249 DOI: 10.3389/fpsyg.2019.00496] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2018] [Accepted: 02/20/2019] [Indexed: 12/22/2022] Open
Abstract
Although many individuals who experience a trauma go on to develop post-traumatic stress disorder (PTSD), the rate of PTSD following trauma is only about 15-24%. There must be some pre-existing conditions that impart increased vulnerability to some individuals and not others. Diathesis models of PTSD theorize that pre-existing vulnerabilities interact with traumatic experiences to produce psychopathology. Recent work has indicated that personality factors such as behavioral inhibition (BI), harm avoidance (HA), and distressed (Type D) personality are vulnerability factors for the development of PTSD and anxiety disorders. These personality temperaments produce enhanced acquisition or maintenance of associations, especially avoidance, which is a criterion symptom of PTSD. In this review, we highlight the evidence for a relationship between these personality types and enhanced avoidance and associative learning, which may increase risk for the development of PTSD. First, we provide the evidence confirming a relationship among BI, HA, distressed (Type D) personality, and PTSD. Second, we present recent findings that BI is associated with enhanced avoidance learning in both humans and animal models. Third, we will review evidence that BI is also associated with enhanced eyeblink conditioning in both humans and animal models. Overall, data from both humans and animals suggest that these personality traits promote enhanced avoidance and associative learning, as well as slowing of extinction in some training protocols, which all support the learning diathesis model. These findings of enhanced learning in vulnerable individuals can be used to develop objective behavioral measures to pre-identify individuals who are more at risk for development of PTSD following traumatic events, allowing for early (possibly preventative) intervention, as well as suggesting possible therapies for PTSD targeted on remediating avoidance or associative learning. Future work should explore the neural substrates of enhanced avoidance and associative learning for behaviorally inhibited individuals in both the animal model and human participants.
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Affiliation(s)
- Michael Todd Allen
- School of Psychological Sciences, University of Northern Colorado, Greeley, CO, United States
- Rutgers Biomedical Health Sciences, Stress and Motivated Behavior Institute, Rutgers University, Newark, NJ, United States
- Central New York Research Corporation, Syracuse, NY, United States
| | - Catherine E. Myers
- Department of Veterans Affairs, VA New Jersey Health Care System, East Orange, NJ, United States
- Department of Pharmacology, Physiology and Neuroscience, Rutgers University-New Jersey Medical School, Newark, NJ, United States
| | - Kevin D. Beck
- Department of Veterans Affairs, VA New Jersey Health Care System, East Orange, NJ, United States
- Department of Pharmacology, Physiology and Neuroscience, Rutgers University-New Jersey Medical School, Newark, NJ, United States
| | - Kevin C. H. Pang
- Department of Veterans Affairs, VA New Jersey Health Care System, East Orange, NJ, United States
- Department of Pharmacology, Physiology and Neuroscience, Rutgers University-New Jersey Medical School, Newark, NJ, United States
| | - Richard J. Servatius
- Rutgers Biomedical Health Sciences, Stress and Motivated Behavior Institute, Rutgers University, Newark, NJ, United States
- Central New York Research Corporation, Syracuse, NY, United States
- Department of Veterans Affairs, Syracuse Veterans Affairs Medical Center, Syracuse, NY, United States
- Department of Psychiatry, State University of New York Upstate Medical University, Syracuse, NY, United States
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14
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Zhang YY, Han WL, Qin W, Yin HX, Zhang CF, Kong C, Wang YL. Extent of compassion satisfaction, compassion fatigue and burnout in nursing: A meta-analysis. J Nurs Manag 2018; 26:810-819. [PMID: 30129106 DOI: 10.1111/jonm.12589] [Citation(s) in RCA: 151] [Impact Index Per Article: 25.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/28/2017] [Indexed: 11/30/2022]
Abstract
AIMS A meta-analysis was conducted of the prevalence rates of compassion satisfaction, compassion fatigue and burnout to identify the factors influencing these rates. BACKGROUND The extents of compassion fatigue and burnout adversely affect nursing efficiency. However, the reported prevalence rates vary considerably. METHODS Data were acquired from electronic databases. Random effects meta-analyses were performed to obtain pooled estimates of the prevalence rates of compassion satisfaction, compassion fatigue and burnout and their respective instrumental scores. Meta-regression analyses were performed to identify factors influencing these rates. RESULTS Data from 21 studies were used for the meta-analysis. The prevalence rates of compassion satisfaction, compassion fatigue and burnout were 47.55%, 52.55% and 51.98%, respectively. The possession of Bachelor's or Master's degrees by the nurses was significantly inversely associated with the percent prevalence of compassion fatigue (coefficient: -1.187) and burnout (coefficient: -0.810). The compassion fatigue score was also significantly inversely associated with nursing status as registered or licensed practical nurse (coefficient: -0.135). CONCLUSION In nursing, the prevalence rates of compassion fatigue and burnout are high. Better education and training may have a moderating effect on compassion fatigue and burnout and could improve the quality of life of nurses.
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Affiliation(s)
- Ying-Ying Zhang
- Department of Paediatrics, Affiliated Hospital of Jining Medical University, Jining, Shandong, China
| | - Wen-Li Han
- Department of Paediatrics, Affiliated Hospital of Jining Medical University, Jining, Shandong, China
| | - Wen Qin
- Department of Paediatrics, Affiliated Hospital of Jining Medical University, Jining, Shandong, China
| | - Hai-Xia Yin
- Department of Paediatrics, Affiliated Hospital of Jining Medical University, Jining, Shandong, China
| | - Chong-Fang Zhang
- Department of Paediatrics, Affiliated Hospital of Jining Medical University, Jining, Shandong, China
| | - Cui Kong
- Nursing Department, Affiliated Hospital of Jining Medical University, Jining, Shandong, China
| | - Ying-Lei Wang
- Urology Department, Affiliated Hospital of Jining Medical University, Jining, Shandong, China
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15
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Allen MT. A computer-based avatar task designed to assess behavioral inhibition extends to behavioral avoidance but not cognitive avoidance. PeerJ 2018; 6:e5330. [PMID: 30083462 PMCID: PMC6074773 DOI: 10.7717/peerj.5330] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2018] [Accepted: 07/06/2018] [Indexed: 11/20/2022] Open
Abstract
Avoidance is a common feature of post-traumatic stress disorder (PTSD) as well as anxiety and depressive disorders. Avoidance can be expressed behaviorally as well as cognitively. Most personality assessments for avoidance involve self-report inventories which are susceptible to biased responding. The avatar task (Myers et al., 2016a) was developed as an objective measure of behavioral inhibition (BI) which is defined as a tendency for avoidance of unfamiliar people and situations. The avatar task has been demonstrated to screen avoidant behaviors related to BI, PTSD, as well as harm avoidance (HA) as measured by the Tridimensional Personality Questionnaire (TPQ). In the current work, the avatar task was tested with cognitive as well as behavioral avoidance as measured by the cognitive-behavioral avoidance scale (CBAS; Ottenbreit & Dobson, 2004). The CBAS includes four subscales which measure behavioral social (BS) avoidance, behavioral non-social (BN) avoidance, cognitive social (CS) avoidance, and cognitive non-social (CN) avoidance. It was hypothesized that avatar scores would be significantly positively related to behavioral, but not cognitive, avoidance. In addition, it was also hypothesized that performance on the avatar task would be more related to social than non-social behavioral avoidance. Participants completed the avatar task, the HA scale of the TPQ and the CBAS. Pearson's product moment correlations revealed that avatar scores were significantly related to CBAS total scores as well as BS and BN scores, but not CS and CN scores. In addition, BS has a stronger relationship with avatar scores than BN avoidance which fits with the social aspects of the scenarios in the avatar task. A median split of the avatar scores produced a significant difference in scores on the behavioral but not the cognitive subscales. Overall, the current results supported the idea that the avatar task is measuring behavioral avoidance, specifically in social situations, rather than cognitive avoidance. Future work could adapt the avatar task to include scenarios similar to the cognitive items on the CBAS to create an objective measure of cognitive avoidance which may be relevant in measuring avoidance in depression and behavioral avoidance associated with PTSD as well as anxiety disorders.
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Affiliation(s)
- M Todd Allen
- School of Psychological Sciences, University of Northern Colorado, Greeley, CO, United States of America
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16
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Zhang YY, Zhang C, Han XR, Li W, Wang YL. Determinants of compassion satisfaction, compassion fatigue and burn out in nursing: A correlative meta-analysis. Medicine (Baltimore) 2018; 97:e11086. [PMID: 29952947 PMCID: PMC6242309 DOI: 10.1097/md.0000000000011086] [Citation(s) in RCA: 117] [Impact Index Per Article: 19.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Compassionate care is essential for better clinical and patient outcomes, but during healthcare provision it can be compromised by several factors. This study evaluates factors affecting compassion satisfaction, compassion fatigue and burnout in nursing. METHODS Literature search in electronic databases was followed by data extraction, conversion, and meta-analyses under random effect model. Correlation coefficients (r) reported by individual studies were first converted to z-scores for meta-analyses and the overall effect sizes were then back-transformed into r. RESULTS Eleven studies (4054 respondents; 64.34 [95% confidence interval: 38.82, 89.86] % response rate; age 39.81 [31.36, 48.27] years; 87.11 [79.48, 94.73] % females) were used for meta-analysis. There was a strong positive correlation between compassion fatigue and burnout (r = 0.59), whereas compassion satisfaction had weak negative correlation with compassion fatigue (r = -0.226) but moderate with burnout (r = -0.446). Stress and negative affect were moderately positively associated with compassion fatigue (r = 0.405) but weakly correlated with burnout (r = 0.119). Positive affect and personal/social factors had weak inverse relationship with burnout (r = -0.197). Positive affect also had a moderately positive relationship with compassion satisfaction (r = 0.396). Demographic or professional factors were not significantly related to compassion satisfaction, compassion fatigue, or burnout. CONCLUSION In nursing, a variety of stressful factors and negative affect promote compassion fatigue and burnout whereas positive affect is helpful in achieving compassion satisfaction.
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Affiliation(s)
- Ying-ying Zhang
- Outpatient Department, Affiliated Hospital of Jining Medical University, Jining
| | - Cheng Zhang
- Department of Neurology, Zouping County People's Hospital, Binzhou, Shandong
| | - Xiao-Rong Han
- Department of Respiratory Intervention, Qilu Children's Hospital of Shandong University
| | | | - Ying-lei Wang
- Urology Department, Affiliated Hospital of Jining Medical University, Jining, Shandong, China
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17
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Jones AC, Badour CL, Alex Brake C, Hood CO, Feldner MT. Facets of Emotion Regulation and Posttraumatic Stress: An Indirect Effect via Peritraumatic Dissociation. COGNITIVE THERAPY AND RESEARCH 2018; 42:497-509. [PMID: 32952232 DOI: 10.1007/s10608-018-9899-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
Research suggests important associations between emotion regulation difficulties and posttraumatic stress disorder (PTSD) symptomology, with prospective studies indicating that emotion regulation difficulties may lead to increased PTSD symptoms. Peritraumatic dissociation is considered an important and consistent predictor of PTSD symptoms. The present study examines whether peritraumatic dissociation accounts for associations between facets of emotion regulation difficulties and PTSD symptoms. Adult women with a history of sexual victimization participated in an interview to assess past-month PTSD symptoms and self-report questionnaires to assess peritraumatic dissociation and emotion regulation difficulties. Results showed a partial indirect effect of three facets of emotion regulation difficulties (i.e., nonacceptance of negative emotional responses, limited access to emotion regulation strategies perceived as effective in the context of distress, and impulse control difficulties when experiencing negative emotions) on PTSD symptoms through peritraumatic dissociation. Reverse indirect effects models were also explored. The present study offers preliminary evidence that peritraumatic dissociation by traumatized individuals may signal the presence of specific emotion regulation deficits, which may indicate increased risk of heightened PTSD severity.
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18
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Aho N, Proczkowska Björklund M, Svedin CG. Peritraumatic reactions in relation to trauma exposure and symptoms of posttraumatic stress in high school students. Eur J Psychotraumatol 2017; 8:1380998. [PMID: 29163861 PMCID: PMC5687802 DOI: 10.1080/20008198.2017.1380998] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2017] [Accepted: 09/09/2017] [Indexed: 11/08/2022] Open
Abstract
Background: Exposure to traumatic events is clearly associated with a diversity of subsequent mental health problems, with posttraumatic stress disorder (PTSD) as the most prevalent disorder. Epidemiologically, trauma exposure rates are more prevalent than PTSD, indicating that most trauma victims do not develop PTSD. More knowledge is needed to understand the development of the different posttraumatic pathways including the significance of pretraumatic, peritraumatic and posttraumatic risk factors. Objective: To study peritraumatic reactions in relation to trauma exposure and symptoms of posttraumatic stress and to enhance our understanding of peritraumatic reactions as mediators between trauma and later symptomatology. Method: The study was composed of a representative community sample of 5332 second year high school students (mean age 17.3 years) who completed the Juvenile Victimization Questionnaire (SAQ/JVQ), Trauma Symptom Checklist for Children (TSCC) and answered questions about peritraumatic reactions. Mediation effects of peritraumatic reactions on the trauma exposure relationship to symptoms was tested using the PROCESS macro for SPSS. Results: Traumatic events are common (84.1%) and are accompanied in three-quarters of the students with at least one form of peritraumatic reaction. Peritraumatic reactions, especially peritraumatic dissociative reactions, mediate the relationship between trauma exposure and symptoms, and gender moderates the effect of peritraumatic dissociation. This moderating effect was found to be larger for boys than for girls, indicating gender differences in response to trauma. Conclusions: The results indicate the need to screen for peritraumatic reactions as early as possible after a traumatic event in order to identify those at risk for PTSD.
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Affiliation(s)
- Nikolas Aho
- Linköping University, Department of Clinical and Experimental Medicine, Child and Adolescent Psychiatry, Linköping, Sweden
| | - Marie Proczkowska Björklund
- Linköping University, Department of Clinical and Experimental Medicine, Child and Adolescent Psychiatry, Linköping, Sweden
| | - Carl Göran Svedin
- Linköping University, Department of Clinical and Experimental Medicine, Child and Adolescent Psychiatry, Linköping, Sweden
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19
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McCanlies EC, Sarkisian K, Andrew ME, Burchfiel CM, Violanti JM. Association of peritraumatic dissociation with symptoms of depression and posttraumatic stress disorder. PSYCHOLOGICAL TRAUMA-THEORY RESEARCH PRACTICE AND POLICY 2016; 9:479-484. [PMID: 27869465 DOI: 10.1037/tra0000215] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
AIM In this study, we evaluated whether peritraumatic dissociation (PD) was associated with symptoms of depression and posttraumatic stress disorder (PTSD), and whether this association was modified by trauma prior to police work. METHOD Symptoms of depression, PTSD, peritraumatic dissociative experience (PDE), and trauma prior to police work were measured using the Center for Epidemiologic Studies Depression scale, PTSD Checklist-Civilian, PDE questionnaire, and the Brief Trauma questionnaire, respectively, in 328 police officers. Separate regression models were used to assess if either symptoms of depression or PTSD were associated with PD stratified by prior trauma. Means were adjusted for race, number of drinks per week, and smoking. RESULTS PD was associated with symptoms of PTSD and depression (β = 0.65, p < .001 and β = 0.27, p < .001, respectively). PD was positively associated with symptoms of PTSD regardless of prior trauma (β = 0.61, p < .001(without prior trauma), 0.75, p < .001 (with prior trauma). In contrast to PTSD, depression symptoms were significantly associated with PD scores in individuals with prior trauma (β = 0.47, p < .001), but not in individuals without prior trauma (β = 0.13, p = .165). LIMITATIONS This is a cross-sectional study. Outcomes were obtained via self-report and were not clinically diagnosed. Aspects of both the trauma event as well as the symptoms and severity of PD may have introduced recall bias. CONCLUSION These results add to the literature indicating that PD plays a role in symptoms of PTSD and depression and how prior trauma may modify this relationship. (PsycINFO Database Record
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Affiliation(s)
- Erin C McCanlies
- Health Effects Laboratory Division, Biostatistics and Epidemiology Branch, National Institute for Occupational Safety and Health
| | - Khachatur Sarkisian
- Health Effects Laboratory Division, Biostatistics and Epidemiology Branch, National Institute for Occupational Safety and Health
| | - Michael E Andrew
- Health Effects Laboratory Division, Biostatistics and Epidemiology Branch, National Institute for Occupational Safety and Health
| | - Cecil M Burchfiel
- Health Effects Laboratory Division, Biostatistics and Epidemiology Branch, National Institute for Occupational Safety and Health
| | - John M Violanti
- Department of Epidemiology and Environmental Health, University at Buffalo, State University of New York
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20
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Pavšič Mrevlje T. Coping with Work-related Traumatic Situations among Crime Scene Technicians. Stress Health 2016; 32:374-382. [PMID: 25641805 DOI: 10.1002/smi.2631] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2014] [Revised: 12/01/2014] [Accepted: 12/02/2014] [Indexed: 11/06/2022]
Abstract
Crime scene technicians collect evidence related to crime and are therefore exposed to many traumatic situations. The coping strategies they use are thus very important in the process of facing the psychological consequences of such work. The available literature shows that crime scene technicians are an understudied subgroup of police workers. Our study is therefore the first unfolding insights into technicians' coping strategies, post-traumatic symptomatology and somatic health, based on a sample of 64 male crime scene technicians (85% of all Slovene technicians). Crime scene technicians mainly use avoidance coping strategies. Approach strategies that are more effective in the long-term-i.e. lead to a larger buffering of the effects of traumatic stress-are more frequently used if technicians are familiar with the nature of the task, when they have time to prepare for it, and if they feel that past situations have been positively resolved. Behavioural avoidance strategies were found to be least effective when dealing with traumatic experiences and are also related to more frequent problems of physical health. Results indicate that appropriate trainings for future technicians would facilitate the use of more effective coping strategies and consequently lead to a more effective and satisfied worker. Copyright © 2014 John Wiley & Sons, Ltd.
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21
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Giele CL, van den Hout MA, Engelhard IM, Dek ECP, Toffolo MBJ, Cath DC. Perseveration induces dissociative uncertainty in obsessive-compulsive disorder. J Behav Ther Exp Psychiatry 2016; 52:1-10. [PMID: 26901818 DOI: 10.1016/j.jbtep.2016.02.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2015] [Revised: 02/04/2016] [Accepted: 02/05/2016] [Indexed: 11/18/2022]
Abstract
BACKGROUND AND OBJECTIVES Obsessive compulsive (OC)-like perseveration paradoxically increases feelings of uncertainty. We studied whether the underlying mechanism between perseveration and uncertainty is a reduced accessibility of meaning ('semantic satiation'). METHODS OCD patients (n = 24) and matched non-clinical controls (n = 24) repeated words 2 (non-perseveration) or 20 times (perseveration). They decided whether this word was related to another target word. Speed of relatedness judgments and feelings of dissociative uncertainty were measured. The effects of real-life perseveration on dissociative uncertainty were tested in a smaller subsample of the OCD group (n = 9). RESULTS Speed of relatedness judgments was not affected by perseveration. However, both groups reported more dissociative uncertainty after perseveration compared to non-perseveration, which was higher in OCD patients. Patients reported more dissociative uncertainty after 'clinical' perseveration compared to non-perseveration.. LIMITATIONS Both parts of this study are limited by some methodological issues and a small sample size. CONCLUSIONS Although the mechanism behind 'perseveration → uncertainty' is still unclear, results suggest that the effects of perseveration are counterproductive.
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Affiliation(s)
- Catharina L Giele
- Department of Clinical and Health Psychology, Utrecht University, Utrecht, The Netherlands.
| | - Marcel A van den Hout
- Department of Clinical and Health Psychology, Utrecht University, Utrecht, The Netherlands
| | - Iris M Engelhard
- Department of Clinical and Health Psychology, Utrecht University, Utrecht, The Netherlands; Altrecht Academic Anxiety Centre, Utrecht, The Netherlands
| | - Eliane C P Dek
- Department of Clinical and Health Psychology, Utrecht University, Utrecht, The Netherlands
| | - Marieke B J Toffolo
- Department of Clinical and Health Psychology, Utrecht University, Utrecht, The Netherlands
| | - Danielle C Cath
- Department of Clinical and Health Psychology, Utrecht University, Utrecht, The Netherlands; Altrecht Academic Anxiety Centre, Utrecht, The Netherlands
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22
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Kang P, Lv Y, Hao L, Tang B, Liu Z, Liu X, Liu Y, Zhang L. Psychological consequences and quality of life among medical rescuers who responded to the 2010 Yushu earthquake: A neglected problem. Psychiatry Res 2015; 230:517-23. [PMID: 26476590 DOI: 10.1016/j.psychres.2015.09.047] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2015] [Revised: 07/16/2015] [Accepted: 09/29/2015] [Indexed: 10/23/2022]
Abstract
A comprehensive study was conducted 8 months after the 2010 Yushu earthquake to assess the prevalence of posttraumatic stress disorder (PTSD) among medical rescuers and the rescuers' quality of life. Additionally, the study examines differences between local and supporting forces, as well as the relationship between PTSD and lower quality of life (QoL), and the risk factors for both. A total of 338 rescuers (including 123 local rescuers and 215 supporting ones) were randomly selected from Yushu County (the epicenter) and Xining City using multistage systematic sampling. Two standardized instruments, the PTSD Checklist-Civilian Version (PCL-C) and the Chinese version of the WHOQOL-BREF, were used to evaluate the prevalence of PTSD and obtain the rescuers' QoL. Being between 40 and 50 years old, a nurse, Tibetan, having been in serious danger or having received mental health training before this earthquake were significantly and independently associated with PTSD symptoms. Compared with supporting rescuers, local rescuers were more likely to develop PTSD and to report a lower QoL. Additional mental health services and training should be available to at-risk medical rescuers and groups to ensure they are adequately prepared for relief efforts and to maintain their mental health after assistance in disaster relief.
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Affiliation(s)
- Peng Kang
- Department of Military Health Management, College of Military Health Management, Second Military Medical University, Shanghai 200433, China
| | - Yipeng Lv
- Department of Military Health Management, College of Military Health Management, Second Military Medical University, Shanghai 200433, China
| | - Lu Hao
- Office of Teaching and Training, Division of Graduate, Second Military Medical University, Shanghai 200433, China
| | - Bihan Tang
- Department of Military Health Management, College of Military Health Management, Second Military Medical University, Shanghai 200433, China
| | - Zhipeng Liu
- Department of Military Health Management, College of Military Health Management, Second Military Medical University, Shanghai 200433, China
| | - Xu Liu
- Department of Military Health Management, College of Military Health Management, Second Military Medical University, Shanghai 200433, China
| | - Yuan Liu
- Department of Military Health Management, College of Military Health Management, Second Military Medical University, Shanghai 200433, China
| | - Lulu Zhang
- Department of Military Health Management, College of Military Health Management, Second Military Medical University, Shanghai 200433, China.
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23
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Mangoulia P, Koukia E, Alevizopoulos G, Fildissis G, Katostaras T. Prevalence of Secondary Traumatic Stress Among Psychiatric Nurses in Greece. Arch Psychiatr Nurs 2015; 29:333-8. [PMID: 26397438 DOI: 10.1016/j.apnu.2015.06.001] [Citation(s) in RCA: 67] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2014] [Revised: 06/07/2015] [Accepted: 06/11/2015] [Indexed: 11/17/2022]
Abstract
The aim of this study was to investigate the prevalence of secondary traumatic stress/compassion fatigue (STS/CF), burnout (BO) and compassion satisfaction (CS) in psychiatric nurses, and their risk factors. The Professional Quality of Life Scale (ProQOL R-IV) and a demographic and work related characteristics questionnaire were distributed to 174 psychiatric nurses in 12 public hospitals in Greece. The majority of participants were at the high risk category for STS/CF (44.8%) and BO (49.4%), while only 8.1% of nurses expressed high potential for CS. Awareness of the factors associated with STS may help nurses to prevent or offset the development of this condition.
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Affiliation(s)
- Polyxeni Mangoulia
- Faculty of Nursing, National and Kapodistrian University of Athens, Athens, Greece.
| | - Evmorfia Koukia
- Faculty of Nursing, National and Kapodistrian University of Athens, Athens, Greece
| | - George Alevizopoulos
- Faculty of Nursing, National and Kapodistrian University of Athens, Athens, Greece
| | - George Fildissis
- Faculty of Nursing, National and Kapodistrian University of Athens, Athens, Greece
| | - Theofanis Katostaras
- Faculty of Nursing, National and Kapodistrian University of Athens, Athens, Greece
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24
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Pinto RJ, Henriques SP, Jongenelen I, Carvalho C, Maia ÂC. The Strongest Correlates of PTSD for Firefighters: Number, Recency, Frequency, or Perceived Threat of Traumatic Events? J Trauma Stress 2015; 28:434-40. [PMID: 26389531 DOI: 10.1002/jts.22035] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Firefighters experience a wide range of traumatic events while on duty and are at risk to develop psychopathology and posttraumatic stress disorder (PTSD). According to cognitive models, the person's interpretation of the traumatic event is responsible for the development of PTSD rather than the traumatic event itself. This cross-sectional study aimed to explore the contribution of perceived threat to explain PTSD symptoms in Portuguese firefighters, after adjusting for potential confounding factors. A sample of 397 firefighters completed self-report measures of exposure to traumatic events, psychopathology, and PTSD. Perceived threat explained unique variance in PTSD symptoms, R(2) = .40, ΔR(2) = .02, F(10, 367) = 24.55, p < .001, Cohen's f(2) =.03, after adjusting for psychopathology, number, recency, and frequency of the events, and other potential confounding variables. The association between psychopathology and PTSD was also moderated by perceived threat, R(2) = .43, ΔR(2) = .03, F(11, 366) = 25.33, p < .001, Cohen's f(2) =.05. Firefighters may benefit from interventions that focus on perceived threat to prevent PTSD symptoms.
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Affiliation(s)
- Ricardo J Pinto
- Faculty of Psychology, University of Lusófona, Porto, Portugal
| | | | - Inês Jongenelen
- Faculty of Psychology, University of Lusófona, Porto, Portugal
| | | | - Ângela C Maia
- School of Psychology, University of Minho, Braga, Portugal
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25
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Regambal MJ, Alden LE, Wagner SL, Harder HG, Koch WJ, Fung K, Parsons C. Characteristics of the traumatic stressors experienced by rural first responders. J Anxiety Disord 2015; 34:86-93. [PMID: 26188614 DOI: 10.1016/j.janxdis.2015.06.006] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2014] [Revised: 06/12/2015] [Accepted: 06/15/2015] [Indexed: 11/25/2022]
Abstract
First responders routinely experience work-related events that meet the definition of a traumatic stressor. Despite the high exposure to traumatic events, prevalence rates of posttraumatic stress disorder (PTSD) are relatively low. This discrepancy points to the potential value of identifying factors that distinguish those traumatic stressors that produce ongoing traumatic stress symptoms from those that do not. The present study surveyed 181 first responders from rural settings. A repeated-measures design was used to compare characteristics of traumatic stressors that were or were not associated with ongoing PTSD symptoms. A factor analysis revealed that distressing events were characterized by chaos and resource limitations. Consistent with contemporary models, two mediational analyses revealed that each event characteristic predicted peritraumatic dissociation and posttraumatic cognitions, which in turn predicted PTSD symptoms. Moreover, the effect of each event characteristic on PTSD symptoms was partially mediated by these cognitive processes.
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Affiliation(s)
- Marci J Regambal
- Department of Psychology, University of British Columbia, 2136 West Mall, Vancouver, British Columbia, Canada V6T 1Z4
| | - Lynn E Alden
- Department of Psychology, University of British Columbia, 2136 West Mall, Vancouver, British Columbia, Canada V6T 1Z4.
| | - Shannon L Wagner
- School of Health Sciences, University of Northern British Columbia, 3333 University Way, Prince George, British Columbia, Canada V2N 4Z9
| | - Henry G Harder
- School of Health Sciences, University of Northern British Columbia, 3333 University Way, Prince George, British Columbia, Canada V2N 4Z9
| | - William J Koch
- Department of Psychiatry, University of British Columbia, Detwiller Pavilion, 2255 Westbrook Mall, Vancouver, British Columbia, Canada V6T 2A1
| | - Klint Fung
- Department of Psychology, University of British Columbia, 2136 West Mall, Vancouver, British Columbia, Canada V6T 1Z4
| | - Carly Parsons
- Department of Psychology, University of British Columbia, 2136 West Mall, Vancouver, British Columbia, Canada V6T 1Z4
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26
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Tang B, Ge Y, Liu Z, Liu X, Kang P, Liu Y, Zhang L. Health-related quality of life for medical rescuers one month after Ludian earthquake. Health Qual Life Outcomes 2015; 13:88. [PMID: 26108679 PMCID: PMC4479311 DOI: 10.1186/s12955-015-0286-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2015] [Accepted: 06/15/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND An earthquake struck Ludian in Yunnan province of China on August 3, 2014, resulting in 3143 injuries, 617 deaths, and 112 missing persons. Our study aimed at estimating the quality of life and associated determinants among medical rescuers after Ludian earthquake. METHODS A cross-sectional survey was performed among personnel from three hospitals that assumed rescue tasks in Ludian earthquake. Descriptive statistics, t-tests, ANOVA and stepwise linear regression analysis were used for data analysis. RESULTS The mean scores on the physical component summary (PCS) and mental component summary (MCS) were 49.86 (SD = 6.01) and 35.85(SD = 6.90), respectively. Lower PCS in the aftermath of an earthquake was associated with non-military medical rescuers, elderly age, and being trapped/in danger while lower MSC in the aftermath of an earthquake was associated with non-military medical rescuers, young age, being female, being trapped/in danger and low education degree. CONCLUSIONS In conclusion, our study demonstrates that medical rescuers are at risk for a lower HRQoL after exposure to Ludian earthquake. The results of this study help expand our knowledge of health-related quality of life among medical rescuers after the Ludian earthquake.
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Affiliation(s)
- Bihan Tang
- Institute of Military Health Management, Second Military Medical University, 800 Xiangyin Rd, Shanghai, 200433, China.
| | - Yang Ge
- Institute of Military Health Management, Second Military Medical University, 800 Xiangyin Rd, Shanghai, 200433, China.
| | - Zhipeng Liu
- Institute of Military Health Management, Second Military Medical University, 800 Xiangyin Rd, Shanghai, 200433, China.
| | - Xu Liu
- Institute of Military Health Management, Second Military Medical University, 800 Xiangyin Rd, Shanghai, 200433, China.
| | - Peng Kang
- Institute of Military Health Management, Second Military Medical University, 800 Xiangyin Rd, Shanghai, 200433, China.
| | - Yuan Liu
- Institute of Military Health Management, Second Military Medical University, 800 Xiangyin Rd, Shanghai, 200433, China.
| | - Lulu Zhang
- Institute of Military Health Management, Second Military Medical University, 800 Xiangyin Rd, Shanghai, 200433, China.
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De Soir E, Zech E, Versporten A, Van Oyen H, Kleber R, Mylle J, van der Hart O. Degree of exposure and peritraumatic dissociation as determinants of PTSD symptoms in the aftermath of the Ghislenghien gas explosion. ACTA ACUST UNITED AC 2015; 73:21. [PMID: 25897400 PMCID: PMC4403847 DOI: 10.1186/s13690-015-0069-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2015] [Accepted: 02/25/2015] [Indexed: 02/07/2023]
Abstract
BACKGROUND This paper investigates risk factors for the development of posttraumatic stress symptoms in the different survivor groups involved in a technological disaster in Ghislenghien (Belgium). A gas explosion instantly killed five firefighters, one police officer and 18 other people. Moreover, 132 people were wounded among which many suffered severe burn injuries. METHODS In the framework of a large health survey of people potentially involved in the disaster, data were collected from 3,448 households, of which 7,148 persons aged 15 years and older, at 5 months (T1) and at 14 months (T2) after the explosion. Hierarchical regression was used to determine the significant predictors and to assess their proportion in variance accounted for. RESULTS The degree of exposure to the disaster was a predictor of the severity of posttraumatic stress symptoms. Peritraumatic dissociation appeared to be the most important predictor of the development of posttraumatic stress symptoms at T1. But at T2, posttraumatic stress symptoms at T1 had become the most important predictor. Dissatisfaction with social support was positively linked to development of posttraumatic stress symptoms at T1 and to the maintenance of these symptoms at T2. Survivors who received psychological help reported significant benefits. CONCLUSIONS In harmony with the findings from studies on technological disasters, at T1 6,0% of the respondents showed sufficient symptoms to meet all criteria for a full PTSD. At T2, 6,6% still suffered from posttraumatic stress symptoms. The symptoms of the different victim categories clearly indicated the influence of the degree of exposure on the development of posttraumatic stress symptoms. Problems inherent to retrospective scientific research after a disaster are discussed.
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Affiliation(s)
- Erik De Soir
- Department of Scientific and Technological Research, Royal Higher Institute of Defence, Avenue de la Renaissance, 30 B-1000 Brussels, Belgium
| | - Emmanuelle Zech
- Faculty of Pychology and Educational Sciences, Research Center for Health and Psychological Development, Université catholique de Louvain, Place du Cardinal Mercier 10, B-1348 Louvain la Neuve, Belgium
| | - Ann Versporten
- Vaccine & Infectuous Disease Institute (VAXINFECTIO), Faculty of Medicine and Health Science, Laboratory of Medical Microbiology, University of Antwerp, Universiteitsplein 1, B-2630 Antwerp, Belgium
| | - Herman Van Oyen
- Scientific Institute of Public Health, Direction Public Health and Surveillance, J. Wytsmanstreet 14, B-1050 Brussels, Belgium
| | - Rolf Kleber
- Department of Clinical and Health Psychology/Arq Psychotrauma Expert Group, Faculty of Social Sciences, Utrecht University, Utrecht/Diemen, The Netherlands
| | - Jacques Mylle
- Department of Behavioral Sciences, Royal Military Academy, Avenue de la Renaissance 30, B-1000 Brussels, Belgium
| | - Onno van der Hart
- Department of Clinical and Health Psychology, Faculty of Social Sciences, Utrecht University, Utrecht, The Netherlands
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Voronova EI. [The systematics of psychogenic depressions (reactions of complicated grief)]. Zh Nevrol Psikhiatr Im S S Korsakova 2015; 115:31-39. [PMID: 26978492 DOI: 10.17116/jnevro201511511231-39] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE Reactive depression provoked by the loss of loved ones is a controversial problem of modern psychiatry based on the diametrically opposite conceptions. The author suggests a clinical typology of these depressions based on a psychopathological analysis of trigger mechanisms and constitutional predisposition. MATERIAL AND METHODS Fifty-five patients, aged from 31 to 65 years (mean age 46.9±13.9 years), were examined. The course of depression, including previous psychogenia, was followed up for 5-15 years (mean 11.5±3.6 years). RESULTS AND CONCLUSION Three types of catathymic complexes (affective dissonance, affective resonance and affective imbalance) can be considered as a significant parameter responsible for trigger mechanisms of these psychogenias and their further dynamics. Each type determines not only the psychopathological structure of psychogenic depression but has a predictive validity thus allowing to predict the dynamics of depression and its nosological attribution.
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Affiliation(s)
- E I Voronova
- Sechenov First Moscow State Medical University, Moscow, Mental Health Research Center, Moscow
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Meffert SM, Henn-Haase C, Metzler TJ, Qian M, Best S, Hirschfeld A, McCaslin S, Inslicht S, Neylan TC, Marmar CR. Prospective study of police officer spouse/partners: a new pathway to secondary trauma and relationship violence? PLoS One 2014; 9:e100663. [PMID: 24987848 PMCID: PMC4079247 DOI: 10.1371/journal.pone.0100663] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2013] [Accepted: 05/29/2014] [Indexed: 11/18/2022] Open
Abstract
INTRODUCTION It has been reported that posttraumatic stress disorder (PTSD) is associated with secondary spouse/partner (S/P) emotional distress and relationship violence. OBJECTIVE To investigate the relationships between PTSD, S/P emotional distress and relationship violence among police recruits using a prospective design. METHODS Two hypotheses were tested in 71 S/Ps: (1) Police officer reports of greater PTSD symptoms after 12 months of police service will be associated with greater secondary trauma symptoms among S/Ps; (2) Greater secondary trauma symptoms among S/Ps at 12 months will be associated with S/P reports of greater relationship violence. METHODS 71 police recruits and their S/Ps were assessed at baseline and 12 months after the start of police officer duty. Using linear and logistic regression, we analyzed explanatory variables for 12 month S/P secondary traumatic stress symptoms and couple violence, including baseline S/P variables and couple violence, as well as exposure and PTSD reports from both S/P and officer. RESULTS S/P perception of officer PTSD symptoms predicted S/P secondary traumatic stress. OS/P secondary trauma was significantly associated with both total couple violence (.34, p = .004) and S/P to officer violence (.35, p = .003). CONCLUSIONS Although results from this relatively small study of young police officers and their S/Ps must be confirmed by larger studies in general populations, findings suggest that S/P perception of PTSD symptoms may play a key role in the spread of traumatic stress symptoms across intimate partner relationships and intimate partner violence in the context of PTSD.
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Affiliation(s)
- Susan M. Meffert
- Department of Psychiatry, University of California San Francisco, San Francisco, California, United States of America
- * E-mail:
| | - Clare Henn-Haase
- Department of Psychiatry, New York University, New York, New York, United States of America
| | - Thomas J. Metzler
- Mental Health Service, San Francisco Veterans Administration Medical Center, San Francisco, California, United States of America
| | - Meng Qian
- Department of Psychiatry, New York University, New York, New York, United States of America
| | - Suzanne Best
- Graduate School of Education and Counseling, Lewis and Clark College, Portland, Oregon, United States of America
| | - Ayelet Hirschfeld
- Mental Health Service, San Francisco Veterans Administration Medical Center, San Francisco, California, United States of America
| | - Shannon McCaslin
- Dissemination and Training Division, National Center for PTSD, Palo Alto, California, United States of America
| | - Sabra Inslicht
- Department of Psychiatry, University of California San Francisco, San Francisco, California, United States of America
- Mental Health Service, San Francisco Veterans Administration Medical Center, San Francisco, California, United States of America
| | - Thomas C. Neylan
- Department of Psychiatry, University of California San Francisco, San Francisco, California, United States of America
- Mental Health Service, San Francisco Veterans Administration Medical Center, San Francisco, California, United States of America
| | - Charles R. Marmar
- Department of Psychiatry, New York University, New York, New York, United States of America
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Lewis GC, Platts-Mills TF, Liberzon I, Bair E, Swor R, Peak D, Jones J, Rathlev N, Lee D, Domeier R, Hendry P, McLean SA. Incidence and predictors of acute psychological distress and dissociation after motor vehicle collision: a cross-sectional study. J Trauma Dissociation 2014; 15:527-47. [PMID: 24983475 PMCID: PMC4182147 DOI: 10.1080/15299732.2014.908805] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
OBJECTIVE We examined the incidence and predictors of peritraumatic distress and dissociation after one of the most common forms of civilian trauma exposure: motor vehicle collision (MVC). METHOD In this study, patients presenting to the emergency department after MVCs who were without serious injury and discharged to home after evaluation (n = 935) completed an emergency department interview evaluating sociodemographic, collision-related, and psychological characteristics. RESULTS The incidence and predictors of distress (Peritraumatic Distress Inventory score ≥23) and dissociation (Michigan Critical Events Perception Scale score >3) were assessed. Distress was present in 355 of 935 patients (38%), and dissociation was present in 260 of 942 patients (28%). These outcomes showed only moderate correlation (r = .45) and had both shared and distinct predictors. Female gender, anxiety symptoms prior to the MVC, and vehicle damage severity predicted both distress and dissociation. Higher socioeconomic status (higher education, higher income, full-time employment) had a protective effect against distress but not dissociative symptoms. Better physical health and worse overall mental health were associated with increased risk of dissociation but not distress. Distress but not dissociation was associated with lower patient confidence in recovery and a longer expected duration of recovery. CONCLUSION There are unique predictors of peritraumatic distress and dissociation. Further work is needed to better understand the neurobiology of peritraumatic distress and dissociation and the influence of these peritraumatic outcomes on persistent psychological sequelae.
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Affiliation(s)
- Gemma C Lewis
- a TRYUMPH Research Program , University of North Carolina , Chapel Hill , North Carolina , USA
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An Y, Fu F, Wu X, Lin C, Zhang Y. Longitudinal Relationships Between Neuroticism, Avoidant Coping, and Posttraumatic Stress Disorder Symptoms in Adolescents Following the 2008 Wenchuan Earthquake in China. JOURNAL OF LOSS & TRAUMA 2013. [DOI: 10.1080/15325024.2012.719351] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Brennstuhl MJ, Tarquinio C, Strub L, Montel S, Rydberg JA, Kapoula Z. Benefits of immediate EMDR vs. eclectic therapy intervention for victims of physical violence and accidents at the workplace: a pilot study. Issues Ment Health Nurs 2013; 34:425-34. [PMID: 23805927 DOI: 10.3109/01612840.2012.759633] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
This study focuses on 34 victims of aggression at the workplace, less than 48 hours following the incident of aggression. We compared victims who received an EMDR emergency protocol (URG-EMDR; n = 19) that we developed with those who received a method of intervention called eclectic therapy (n = 15). The results show that URG-EMDR therapy, provided within 48 hours, resulted in a greater decrease in perceived stress and a lower PCL-S score than eclectic therapy did. The scores were lower in both groups after 24 hours, and after 3 months, the drop was significantly greater among the victims treated with the URG-EMDR protocol; none of the EMDR-treated patients exhibited symptoms of posttraumatic stress.
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The Role of Injury and Trauma-Related Variables in the Onset and Course of Symptoms of Posttraumatic Stress Disorder. J Clin Psychol Med Settings 2013; 20:449-55. [DOI: 10.1007/s10880-012-9348-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Morris MC, Rao U. Psychobiology of PTSD in the acute aftermath of trauma: Integrating research on coping, HPA function and sympathetic nervous system activity. Asian J Psychiatr 2013; 6:3-21. [PMID: 23380312 PMCID: PMC3565157 DOI: 10.1016/j.ajp.2012.07.012] [Citation(s) in RCA: 57] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2012] [Revised: 07/28/2012] [Accepted: 07/30/2012] [Indexed: 12/11/2022]
Abstract
Research on the psychobiological sequelae of trauma has typically focused on long-term alterations in individuals with chronic posttraumatic stress disorder (PTSD). Far less is known about the nature and course of psychobiological risk factors for PTSD during the acute aftermath of trauma. In this review, we summarize data from prospective studies focusing on the relationships among sympathetic nervous system activity, hypothalamic-pituitary-adrenal function, coping strategies and PTSD symptoms during the early recovery (or non-recovery) phase. Findings from pertinent studies are integrated to inform psychobiological profiles of PTSD-risk in children and adults in the context of existing models of PTSD-onset and maintenance. Data regarding bidirectional relations between coping strategies and stress hormones is reviewed. Limitations of existing literature and recommendations for future research are discussed.
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Affiliation(s)
- Matthew C Morris
- Center for Molecular and Behavioral Neuroscience (MCM and UR) and the Department of Psychiatry and Behavioral Sciences (UR), Meharry Medical College, Nashville, TN 37208, United States.
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Finklestein M, Laufer A, Solomon Z. Coping strategies of Ethiopian immigrants in Israel: association with PTSD and dissociation. Scand J Psychol 2012; 53:490-8. [PMID: 22946907 DOI: 10.1111/j.1467-9450.2012.00972.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
UNLABELLED The aim of this study was to examine the relations between coping strategies, posttraumatic stress disorder (PTSD), and dissociation among Jewish Ethiopian refugees in Israel (following exposure to pre-, peri- and post-migration stressful events). METHOD A random sample (N = 478) of three waves of refugees took part in the research (N = 165; N = 169; N = 144). Religiosity, coping strategies, stressful and traumatic events, pre- and peri- migration, post-migration difficulties, posttraumatic symptoms, and dissociation were assessed. RESULTS A significant relationship was found between PTSD symptoms and avoidance coping over and above immigration wave and traumatic events. Dissociation was positively associated with passivity and antisocial coping and negatively associated with social joining and level of religiosity, over and above immigration wave and traumatic events. The findings are discussed in the light of the coping strategies employed by Ethiopian refugees.
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Tarquinio C, Brennstuhl M, Reichenbach S, Rydberg J, Tarquinio P. Prise en charge précoce de victimes de viols et présentation d’un protocole d’urgence de thérapie EMDR. SEXOLOGIES 2012. [DOI: 10.1016/j.sexol.2011.11.013] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Tarquinio C, Brennstuhl M, Reichenbach S, Rydberg J, Tarquinio P. Early treatment of rape victims: Presentation of an emergency EMDR protocol. SEXOLOGIES 2012. [DOI: 10.1016/j.sexol.2011.11.012] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Qouta SR, Palosaari E, Diab M, Punamäki RL. Intervention effectiveness among war-affected children: a cluster randomized controlled trial on improving mental health. J Trauma Stress 2012; 25:288-98. [PMID: 22648703 DOI: 10.1002/jts.21707] [Citation(s) in RCA: 79] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
We examined the effectiveness of a psychosocial intervention in reducing mental health symptoms among war-affected children, and the role of peritraumatic dissociation in moderating the intervention impact on posttraumatic stress symptoms (PTSS). School classes were randomized into intervention (n = 242) and waitlist control (n = 240) conditions in Gaza, Palestine. The intervention group participated in 16 extracurriculum sessions of teaching recovery techniques (TRT) and the controls received normal school-provided support. Participants were 10- to 13-year-old Palestinian girls (49.4%) and boys (50.6%). Data on PTSS, depressive symptoms, and psychological distress were collected at baseline (T1), postintervention (T2), and 6-month follow-up (T3). Peritraumatic dissociation was assessed only at baseline. Regression analyses that took regression to the mean and cluster sampling into account were applied. The results on intervention effectiveness were specific to gender and peritraumatic dissociation. At T2, the intervention significantly reduced the proportion of clinical PTSS among boys, and both the symptom level (R(2) = .24), and proportion of clinical PTSS among girls who had a low level of peritraumatic dissociation. The results have implications for risk-specific tailoring of psychosocial interventions in war conditions.
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Affiliation(s)
- Samir R Qouta
- Department of Psychology, Islamic University Gaza, Gaza City, Palestine
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Otis C, Marchand A, Courtois F. Peritraumatic dissociation as a mediator of peritraumatic distress and PTSD: a retrospective, cross-sectional study. J Trauma Dissociation 2012; 13:469-77. [PMID: 22651680 DOI: 10.1080/15299732.2012.670870] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
The objective of the present article was to examine the mediational significance of peritraumatic dissociation in the relationship between peritraumatic distress and posttraumatic stress disorder (PTSD). A total of 71 individuals with spinal cord injuries completed interviews and questionnaires measuring PTSD symptomatology, peritraumatic dissociation, and peritraumatic distress. Peritraumatic dissociation was found to partially mediate the relationship between peritraumatic distress and PTSD symptomatology. These findings provide support for the hypothesis that peritraumatic distress and peritraumatic dissociation significantly impact PTSD severity. The findings also support the hypothesis that peritraumatic dissociation is provoked by peritraumatic distress. The results further indicate that although peritraumatic dissociation seems to be a significant risk factor for PTSD, it is not necessary for the development of PTSD; the presence of peritraumatic distress may be sufficient. These findings highlight the importance of investigating peritraumatic reactions after a traumatic event in order to identify individuals at risk for developing PTSD. Such a practice may help prevent the development of chronic conditions.
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Affiliation(s)
- Catherine Otis
- Department of Psychology, University of Quebec in Montreal, Montreal, Quebec, Canada.
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Maheshwari N, Yadav R, Singh NP. Group counseling: A silver lining in the psychological management of disaster trauma. J Pharm Bioallied Sci 2011; 2:267-74. [PMID: 21829322 PMCID: PMC3148631 DOI: 10.4103/0975-7406.68509] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2010] [Revised: 07/17/2010] [Accepted: 07/19/2010] [Indexed: 11/29/2022] Open
Abstract
Management of disaster effects, physical or psychological, has been the subject of considerable research. Though physical rehabilitation of the victims of any disaster, whether natural or man-made, receives immediate attention, the management of psychological trauma often remains a challenge for the disaster management machinery, in general, and mental health professionals, in particular. The magnitude of population affected, on the one hand, and lack of sufficient mental health professionals, on the other hand, often hinders the psychological rehabilitation of a cross section of the affected population. We attempt to present an overview of the literature to bring home the understanding of correlates of psychological effects in the mass disaster affected population in this article. It dwells on the efficacy of group counseling as the most appropriate paradigm of primary prevention to check the onset of severe psychological disorders. The article also presents an overview of two case studies: tsunami disaster (Nagapatanam, Tamil Nadu, India) and victims of bomb blast (Dhimajee, Assam, India) to highlight the silver lining in the psychological management of disaster traumas. It is proposed that group counseling can prove to be a most important mental rehabilitation program to further strengthen the efficacy of individual therapeutic interventions.
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Affiliation(s)
- Nidhi Maheshwari
- Strategic Behaviour Division, Defence Institute of Psychological Research, Drdo, Lucknow Road, Timarpur, Delhi - 110 054, India
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Abstract
Emergency service workers continuously face situations where they are in charge of the lives of others, and this can be a risk factor for their mental health. This study aims to determine the psychological impact of exposure to current death and physical injury events in the context of motor vehicle accidents among emergency personnel and which variables better predict posttraumatic stress disorder. Participants were National Institute of Medical Emergency workers (nurses and medical doctors; n= 59) in the north of Portugal. They filled out a trauma exposure and posttraumatic stress disorder scale (PTSD), a scale that assesses distress (General Health Questionnaire 12), a peritraumatic dissociation scale (Peritraumatic Dissociative Experiences Questionnaire) and a coping scale (Ways of Coping Questionnaire). Participants reported high exposure to events evaluated as traumatic, but low prevalence of PTSD. When the relation between exposure, time in emergency, sex, distress symptoms, peritraumatic dissociation, and PTSD symptoms was examined, peritraumatic dissociation and distress were the only predictors of PTSD symptoms, but beyond their contribution direct coping explains PTSD variance. In conclusion, taking into account the contribution of distress and peritraumatic dissociation to predict psychopathological symptoms, and the contribution of coping to lower PTSD scores, education and training should help the professionals deal with these reactions and improve coping, and organizations should support professionals in the most disturbing situations.
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Ben-Porat A, Itzhaky H. The Contribution of Training and Supervision to Perceived Role Competence, Secondary Traumatization, and Burnout Among Domestic Violence Therapists. CLINICAL SUPERVISOR 2011. [DOI: 10.1080/07325223.2011.566089] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Affiliation(s)
- Etzel Cardeña
- Department of Psychology, Lund University, SE-221 00 Lund, Sweden
| | - Eve Carlson
- National Center for Posttraumatic Stress Disorder, Veterans Affairs Palo Alto Health Care System, Palo Alto, California 94303;
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Gender Differences in the Longitudinal Impact of Exposure to Violence on Mental Health in Urban Youth. J Youth Adolesc 2011; 40:1674-90. [DOI: 10.1007/s10964-011-9649-3] [Citation(s) in RCA: 64] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2011] [Accepted: 03/04/2011] [Indexed: 10/18/2022]
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Hodgson RC, Webster RA. Mediating role of peritraumatic dissociation and depression on post-MVA distress: path analysis. Depress Anxiety 2011; 28:218-26. [PMID: 21328635 DOI: 10.1002/da.20774] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2010] [Revised: 09/09/2010] [Accepted: 10/23/2010] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND The aim of this study was to examine the role of pre-trauma, traumatic event, and peri-traumatic psychological characteristics on post-motor vehicle accident (MVA) Posttraumatic Stress Disorder (PTSD) and depression. METHODS The sample comprised 333 (54% female) hospital accident and emergency attendees who completed a self-report postal screening survey approximately 1-month post-accident and 128 (62% female) participants who completed a follow-up survey at 3-months. RESULTS Path analysis (Model 1) showed that dissociation partially mediated the relationship between past emotional problems and initial post-MVA distress, as well as between fear of dying and levels of distress. Level of alertness and perceived accident severity had no direct effects on post-MVA distress. However, higher levels of exposure contributed to distress predominantly in the presence of high levels of fear and subsequent dissociative experiences. When ongoing PTSD and depression symptoms were included (Model 2), feeling depressed/sad at 1-month was the strongest predictor of both PTSD and depression symptom severity at 3-months post-MVA, explaining 53% and 40% of the variance, respectively. Dissociation remained an important mediating variable at both time points. CONCLUSIONS These models show the influence of previous emotional vulnerability factors and the important mediating role of peri-traumatic experiences (in the presence of fear due to increased levels of accident severity) on post-MVA morbidity. Additionally, MVA survivors who report feeling depressed/sad 1-month after their accident are at greater risk of developing both PTSD and depression.
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Affiliation(s)
- Robert C Hodgson
- School of Psychology, University of Newcastle, Callaghan, New South Wales 2308, Australia
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Postintensive care unit psychological burden in patients with chronic obstructive pulmonary disease and informal caregivers: A multicenter study. Crit Care Med 2011; 39:112-8. [PMID: 21037472 DOI: 10.1097/ccm.0b013e3181feb824] [Citation(s) in RCA: 86] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To determine the prevalence and risk factors of symptoms of anxiety, depression, and posttraumatic stress disorder-related symptoms in patients with chronic obstructive pulmonary disease and their relatives after an intensive care unit stay. DESIGN Prospective multicenter study. SETTING Nineteen French intensive care units. SUBJECTS One hundred twenty-six patients with chronic obstructive pulmonary disease who survived an intensive care unit stay and 102 relatives. INTERVENTION None. MEASUREMENTS AND MAIN RESULTS Patients and relatives were interviewed at intensive care unit discharge and 90 days later to assess symptoms of anxiety and depression using Hospital Anxiety and Depression Scale (HADS) and posttraumatic stress disorder-related symptoms using the Impact of Event Scale (IES). At intensive care unit discharge, 90% of patients recollected traumatic psychological events in the intensive care unit. At day 90, we were able to conduct telephone interviews with 53 patients and 47 relatives. Hospital Anxiety and Depression Scale scores indicated symptoms of anxiety and depression in 52% and 45.5% of patients at intensive care unit discharge and in 28.3% and 18.9% on day 90, respectively. Corresponding prevalence in relatives were 72.2% and 25.7% at intensive care unit discharge and 40.4% and 14.9% on day 90, respectively. The Impact of Event Scale indicated posttraumatic stress disorder-related symptoms in 20.7% of patients and 29.8% of relatives on day 90. Peritraumatic dissociation assessed using the Peritraumatic Dissociative Experiences Questionnaire was independently associated with posttraumatic stress disorder-related symptoms in the patients and relatives. Previous intensive care unit experience and recollection of bothersome noise in the intensive care unit predicted posttraumatic stress disorder-related symptoms in the patients. CONCLUSIONS Psychiatric symptoms were found to be common in a group of 126 patients with chronic obstructive pulmonary disease who survived an intensive care unit stay and their relatives at intensive care unit discharge and 90 days later. Peritraumatic dissociation at intensive care unit discharge was found to independently predict posttraumatic stress disorder-related symptoms in this sample of patients and relatives.
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Brousse G, Arnaud B, Roger JD, Geneste J, Bourguet D, Zaplana F, Blanc O, Schmidt J, Jehel L. Management of traumatic events: influence of emotion-centered coping strategies on the occurrence of dissociation and post-traumatic stress disorder. Neuropsychiatr Dis Treat 2011; 7:127-33. [PMID: 21552315 PMCID: PMC3083986 DOI: 10.2147/ndt.s17130] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2011] [Indexed: 01/08/2023] Open
Abstract
Our aim was to assess the influence of the coping strategies employed for the management of traumatic events on the occurrence of dissociation and traumatic disorders. We carried out a 1-year retrospective study of the cognitive management of a traumatic event in 18 subjects involved in the same road vehicle accident. The diagnosis of post-traumatic stress disorder (PTSD) was made for 33.3% of the participants. The participants with a PTSD diagnosis 1 year after the event used emotion-centered strategies during the event more often than did those with no PTSD, P < 0.02. In the year after the traumatic event, our results show a strong link between the intensity of PTSD and the severity of the post-traumatic symptoms like dissociation (P = 0.032) and the use of emotion-centered strategies (P = 0.004). Moreover, the participants who presented Peritraumatic Dissociative Experiences Questionnaire scores above 15 made greater use of emotion-centered coping strategies than did those who did not show dissociation, P < 0.04. Our results confirm that the cognitive management of traumatic events may play an essential role in the development of a state of post-traumatic stress in the aftermath of a violent event.
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Affiliation(s)
- Georges Brousse
- CHU Clermont Ferrand, Unité Urgences Psychiatriques, 28 place Henri Dunant BP 69, 63003 Clermont-Ferrand Cedex 01, France
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Ballenger JF, Best SR, Metzler TJ, Wasserman DA, Mohr DC, Liberman A, Delucchi K, Weiss DS, Fagan JA, Waldrop AE, Marmar CR. Patterns and predictors of alcohol use in male and female urban police officers. Am J Addict 2011; 20:21-9. [PMID: 21175917 PMCID: PMC3592498 DOI: 10.1111/j.1521-0391.2010.00092.x] [Citation(s) in RCA: 70] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
In a large sample of urban police officers, 18.1% of males and 15.9% of females reported experiencing adverse consequences from alcohol use and 7.8% of the sample met criteria for lifetime alcohol abuse or dependence. Female officers had patterns of alcohol use similar to male officers and substantially more than females in the general population. Critical incident exposure and posttraumatic stress disorder (PTSD) symptoms were not associated with level of alcohol use. Greater psychiatric symptoms were related to adverse consequences from alcohol use. There was a noteworthy gender by work stress interaction: greater routine work stress related to lower current alcohol use in female officers.
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Affiliation(s)
- James F Ballenger
- Mental Health Service, Department of Veterans Affairs Medical Center, San Francisco, California, USA
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Bryant RA, Panasetis P. The role of panic in acute dissociative reactions following trauma. BRITISH JOURNAL OF CLINICAL PSYCHOLOGY 2010; 44:489-94. [PMID: 16368028 DOI: 10.1348/014466505x28766] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVE 'Peritraumatic dissociation' refers to alterations in awareness and memory for events that occur during and shortly after a traumatic experience. Despite the prevalence of reported peritraumatic dissociation, little is known about the mechanisms that mediate dissociative responses in the initial period after trauma. One theory suggests that peritraumatic dissociation may be a response to elevated arousal and panic symptoms during trauma. This study investigated panic symptoms that occurs at the time of the trauma and their relationship to ongoing dissociation in acute stress disorder. DESIGN A sample of traumatized people with acute stress disorder or controls were administered a range of psychopathology measures within one month of their trauma. METHOD Fifty-one civilian trauma survivors with either acute stress disorder or no acute stress disorder were administered the acute stress disorder interview, the Impact of Event Scale, the Beck Anxiety Inventory, the Peritraumatic Dissociative Experiences Questionnaire, and the Physical Reactions Scale to index panic reactions during the trauma. RESULTS Hierarchical regression analysis found that panic reactions during the trauma accounted for nearly half of the variance (47%) of peritraumatic dissociation, and subsequent stress reactions accounted for an additional 3% of the variance. CONCLUSIONS These findings are consistent with proposals that acute dissociation is associated with panic symptoms that occur during the traumatic experience. Possible mechanisms for the association of panic and dissociation are discussed.
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Affiliation(s)
- Richard A Bryant
- School of Psychology, University of New South Wales, Sydney, Australia.
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