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Kassa MA, Fenta S, Anbesaw T, Tesfa NA, Zemariam AB, Kassaw GM, Abate BB, Semagn EG. Post-traumatic stress disorder and associated factors among high school students who experienced war in Woldia town. Front Psychiatry 2024; 15:1359370. [PMID: 39081535 PMCID: PMC11286586 DOI: 10.3389/fpsyt.2024.1359370] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Accepted: 05/31/2024] [Indexed: 08/02/2024] Open
Abstract
Background The experience of war in recent time is very common around the world, and the impact is profound on the mental health of the victims, especially among the young population. The most implicated mental health problem is post-traumatic stress disorder, which comes after an exposure to trauma as a severe and long-term result of the traumatic event. Studies in developed countries revealed this finding, but there is insufficient information in developing countries, where much of war and conflict exist and young population live including Ethiopia. Therefore, this study aims to assess the prevalence and associated factors of post-traumatic stress disorder among high school students who experienced war. Objective We assessed the prevalence and factors associated with post-traumatic stress disorder among high school students who experienced war. Methods A multi-centered school base cross-sectional study was conducted from May 23 to June 08, 2022. Data were collected from high school students in Woldia town. Bivariable and multivariable logistic regression was used to identify the independent factors associated with post-traumatic stress disorder. Results A total of 338 of the 410 students participated in this study (94.5% response rate). The prevalence of post-traumatic stress disorder was 39.2%. In the multivariable analysis, poor social support (AOR = 3.40, 95% CI: 1.45, 7.95), depression (AOR = 3.24, 95% CI: 1.69,6.21), high level of perceived stress (AOR = 2.98, 95% CI: 1.61, 5.50), being in war fighting situation (AOR = 2.85, 95% CI: 1.40, 5.78), and witnessing the murder of family members or friends (AOR = 3.05, 95% CI: 1.47, 6.32) were factors significantly associated with post-traumatic stress disorder at a p-value <0.05. Conclusions and recommendations In this study, around two in five of high school students had post-traumatic stress disorder. Independent factors of PTSD were depression, high stress levels, poor social support, witnessing the murder of family members/friends, and being in war fighting situation. We recommend that the Ministry of Education and the Ministry of Health collaborate to integrate mental health services into schools. This focuses on the early detection of students at risk of PTSD, such as those with depression, high perceived stress levels, and exposure to murder or war, and provides necessary social support to prevent PTSD.
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Affiliation(s)
- Mulat Awoke Kassa
- Department of Nursing, College of Health Sciences, Woldia University, Woldia, Ethiopia
| | - Sefineh Fenta
- Department of Public Health, College of Health Sciences, Woldia University, Woldia, Ethiopia
| | - Tamrat Anbesaw
- Department of Psychiatry, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Natnael Amare Tesfa
- School of Medicine, College of Health Sciences, Woldia University, Woldia, Ethiopia
| | - Alemu Birara Zemariam
- Department of Pediatrics and Child Health Nursing, School of Nursing, College of Medicine and Health Science, Woldia University, Woldia, Ethiopia
| | - Genanew Mulugeta Kassaw
- Department of Public Health, College of Health Sciences, Woldia University, Woldia, Ethiopia
| | - Biruk Beletew Abate
- Department of Nursing, College of Health Sciences, Woldia University, Woldia, Ethiopia
| | - Elsabet Gezmu Semagn
- Department of Veterinary Parasitology, School of Veterinary Medicine, Wollo University, Dessie, Ethiopia
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Griffin BR, Harvey L, Dimanopoulos TA, Curtis KA, Gillen T, Kimble RM. Examining the impact of a paediatric trauma family support service on the quality of life of injured children: A longitudinal cohort study. J Pediatr Nurs 2024; 77:e356-e365. [PMID: 38735803 DOI: 10.1016/j.pedn.2024.04.052] [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: 11/01/2023] [Revised: 04/21/2024] [Accepted: 04/28/2024] [Indexed: 05/14/2024]
Abstract
PURPOSE We describe and evaluate the introduction of a trauma family support service (TFSS) in an Australian tertiary paediatric hospital. DESIGN AND METHODS A longitudinal mixed-methods cohort study evaluated the effectiveness of the TFSS on quality of life. PedsQL4.0 and EuroQol 5D-Y scores were collected at 6 and 12 months at intervention and non-intervention sites and outcomes were compared using a two-sample t-test. Qualitative data from field notes collected during the administration of the quality-of-life measures were analysed using inductive content analysis. Data were integrated during the interpretation of results to expand and strengthen findings. RESULTS Data from 192 children were collected (intervention site: 104, control site: 88). Significant increases were seen in the PedsQL and EQ-5D-Y scores at the intervention site compared to the control site at both timepoints, indicating an increase in overall health related quality of life. Two main categories were generated from the qualitative analysis: "Psychosocial impact of trauma" and "Access to psychosocial services." CONCLUSIONS The introduction of a dedicated family support service after paediatric injury improved well-being up to 12 months post injury. PRACTICE IMPLICATIONS Healthcare providers should emphasise dedicated family support services for paediatric trauma patients, focusing on their psychosocial needs and ensuring access to suitable resources. Paediatric nurses are a major part of this service and should contribute to future research, co-designing and implementing these improved family support services to better serve families affected by paediatric trauma.
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Affiliation(s)
- Bronwyn R Griffin
- School of Nursing and Midwifery, Griffith University, Level 7, 62 Graham Street, South Brisbane 4101, Queensland, Australia; Queensland Children's Hospital, 501 Stanley Street, South Brisbane 4101, Queensland, Australia.
| | - Lauren Harvey
- Queensland Children's Hospital, 501 Stanley Street, South Brisbane 4101, Queensland, Australia.
| | - Tanesha A Dimanopoulos
- School of Nursing and Midwifery, Griffith University, Level 7, 62 Graham Street, South Brisbane 4101, Queensland, Australia; Queensland Children's Hospital, 501 Stanley Street, South Brisbane 4101, Queensland, Australia.
| | - Kate A Curtis
- Emergency Services, Illawarra Shoalhaven Local Health District, Wollongong Hospital, Loftus Street, Wollongong 2500, New South Wales, Australia; Faculty of Medicine and Health, The University of Sydney, Susan Wakil School of Nursing and Midwifery, Camperdown 2006, New South Wales, Australia.
| | - Tona Gillen
- Queensland Children's Hospital, 501 Stanley Street, South Brisbane 4101, Queensland, Australia.
| | - Roy M Kimble
- Queensland Children's Hospital, 501 Stanley Street, South Brisbane 4101, Queensland, Australia.
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Agoston AM, Bleacher J, Smith A, Edwards S, Routly M. Longitudinal Associations Between Pain, Risk for Posttraumatic Stress Disorder, Posttraumatic Stress Symptoms, and Pain Characteristics in Children After Unintentional Injury. Clin J Pain 2024; 40:400-408. [PMID: 38499983 DOI: 10.1097/ajp.0000000000001212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Accepted: 03/10/2024] [Indexed: 03/20/2024]
Abstract
OBJECTIVES Approximately 20% of children demonstrate persistent posttraumatic stress symptoms (PTSS) after unintentional injury, with more severe pain intensity predicting concurrent and later PTSS. Examining additional pain characteristics like pain behaviors, impairment related to pain, and subjective experiences of pain might provide additional insight into the mechanisms that reinforce relationships between risk for posttraumatic stress disorder (PTSD), PTSS, and pain. METHODS During hospitalization for unintentional injury, the Screening Tool for Predictors of PTSD (STEPP) was administered and the highest pain score was collected. One month later, the Child PTSD Symptom Scale and PROMIS questionnaires assessed PTSS and pain characteristics respectively, including intensity, interference, behaviors, and quality. RESULTS Correlations between PTSS and PROMIS questionnaires were significant. STEPP predicted future PTSS and all PROMIS questionnaires. The highest pain score predicted future PTSS, as well as pain interference and pain behavior, and did not predict pain intensity and pain quality. When STEPP and highest pain score were combined into a single regression, STEPP and highest pain score predicted future PTSS but only STEPP continued to predict all PROMIS questionnaires. DISCUSSION PTSD risk significantly predicted PTSS and pain characteristics 1 month later. The highest pain score predicted future PTSS and several pain characteristics but no longer had predictive value for pain-related outcomes when combined with PTSD risk. These results indicate that risk factors for PTSD are stronger predictors than pain-related risk factors in predicting pain outcomes. Addressing PTSD risk, as well as pain intensity during hospitalization, may result in improved outcomes for children with unintentional injury.
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Affiliation(s)
- Anna Monica Agoston
- Center for Pain Relief
- Division of Pediatric Anesthesiology, Department of Anesthesiology, Emory University School of Medicine, Atlanta, GA
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Griffin BR, Trenoweth K, Dimanopoulos TA, De Young AC, Cobham VE, Williams H, Kimble R. Co-design of a paediatric post-trauma electronic psychosocial screen. J Pediatr Nurs 2024; 76:52-60. [PMID: 38359545 DOI: 10.1016/j.pedn.2024.02.004] [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: 11/30/2023] [Revised: 02/06/2024] [Accepted: 02/06/2024] [Indexed: 02/17/2024]
Abstract
PURPOSE To optimise care pathways and provide greater transparency of the psychosocial needs of injured children after hospital discharge by extending post-discharge psychosocial screening to children admitted with traumatic injury for ≥24 h. DESIGN AND METHODS This mixed-methods study used a co-design approach informed by the Experience-Based Co-design (EBCD) framework. Interviews with carers were used to evaluate experiences and generate views on psychosocial support interventions. Online surveys by international child psychologists' indicated preferences for a psychosocial screening tool, and clinician-stakeholder consensus meetings facilitated the development of an electronic post-injury psychosocial screening tool. RESULTS Carers found the initial year of follow-up from trauma family support services helpful, appreciating the hospital connection. Flexible follow-up timings and additional resources were mentioned, and most carers were interested in participating in an electronic screening activity to predict their child's coping after injury. Child trauma experts recommended including several screening tools, and the multidisciplinary paediatric trauma service and study investigators collaborated over a year to workshop and reach a consensus on the screening tool and follow-up process. CONCLUSION The multidisciplinary team co-designed an electronic psychosocial screening and follow-up process for families with children with traumatic injuries. This tool improves the visibility of injured children's psychosocial needs post-injury and potentially aids clinical targeted resource allocation for trauma family support services. PRACTICE IMPLICATIONS The study emphasises the significance of specialised psychosocial screening tools in paediatric nursing, especially in trauma care, for understanding patients' psychosocial needs, tailoring follow-up plans, and promoting a patient-centred approach.
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Affiliation(s)
- Bronwyn R Griffin
- Menzies Health Institute Queensland, Griffith University, Nathan Campus, QLD, Australia; Children's Health Queensland Hospital and Health Service, Brisbane, QLD, Australia
| | - Kate Trenoweth
- Children's Health Queensland Hospital and Health Service, Brisbane, QLD, Australia
| | - Tanesha A Dimanopoulos
- Menzies Health Institute Queensland, Griffith University, Nathan Campus, QLD, Australia; Children's Health Queensland Hospital and Health Service, Brisbane, QLD, Australia.
| | - Alexandra C De Young
- Queensland Centre for Perinatal and Infant Mental Health, Children's Health Queensland, Hospital Health Service, Brisbane, QLD, Australia; Child Health Research Centre, Faculty of Medicine, The University of Queensland, Brisbane, QLD, Australia
| | - Vanessa E Cobham
- School of Psychology, The University of Queensland, Brisbane, QLD, Australia; Child and Youth Mental Health Service, Children's Health Queensland, Brisbane, QLD, Australia
| | - Hayley Williams
- Child Health Research Centre, Faculty of Medicine, The University of Queensland, Brisbane, QLD, Australia
| | - Roy Kimble
- Children's Health Queensland Hospital and Health Service, Brisbane, QLD, Australia
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Sölva K, Haselgruber A, Lueger-Schuster B. Resilience in the face of adversity: classes of positive adaptation in trauma-exposed children and adolescents in residential care. BMC Psychol 2023; 11:30. [PMID: 36717951 PMCID: PMC9887823 DOI: 10.1186/s40359-023-01049-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2022] [Accepted: 01/13/2023] [Indexed: 01/31/2023] Open
Abstract
Children and adolescents in residential care often face multiple traumatic experiences. However, some individuals show resilient adaptation. To depict this heterogeneity, the person-centered examination of different classes of adaptation is a powerful tool. Up to date, resilience was insufficiently addressed in this population. Data from 141 children and adolescents in residential care institutions in Austria regarding trauma history, psychopathology, behavioral adjustment, and protective factors were assessed with standardized self-report questionnaires. Distinct classes of adaptation after traumatic experiences were examined with Latent Class Analysis. Class differences regarding traumatic experiences and protective factors were analyzed with χ2 testing. Three classes were identified [resilience (66.18%), mixed psychopathology (13.97%, mixed), high psychopathology (19.85%, high)]. Only males were classified into the resilient class and only females into the high class. The high class differed significantly from the resilient class regarding cumulative trauma history and protective factors. The mixed class did not differ from the resilient class regarding trauma history, however, they differed significantly regarding protective factors. The resilient class was associated with protective factors. Strong gender differences show the relevance of a differentiated evaluation of gender-specific protective factors and resilience indicators. Fostering protective factors may be a suitable approach for tailored intervention measures.
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Affiliation(s)
- Katharina Sölva
- grid.10420.370000 0001 2286 1424Unit of Psychotraumatology, Department of Clinical and Health Psychology, Faculty of Psychology, University of Vienna, Wächtergasse 1, 1010 Vienna, Austria
| | - Alexander Haselgruber
- grid.10420.370000 0001 2286 1424Unit of Psychotraumatology, Department of Clinical and Health Psychology, Faculty of Psychology, University of Vienna, Wächtergasse 1, 1010 Vienna, Austria
| | - Brigitte Lueger-Schuster
- grid.10420.370000 0001 2286 1424Unit of Psychotraumatology, Department of Clinical and Health Psychology, Faculty of Psychology, University of Vienna, Wächtergasse 1, 1010 Vienna, Austria
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Road traffic injuries in Tanzanian children and adolescents: A cross-sectional household survey. Injury 2023; 54:160-167. [PMID: 36496266 DOI: 10.1016/j.injury.2022.11.052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Revised: 11/09/2022] [Accepted: 11/23/2022] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To measure annual rates of road traffic injuries (RTI) and to describe the characteristics of road traffic crashes experienced by children and adolescents in Tanga, Tanzania. METHODS We conducted a cross-sectional household survey using geospatial population-weighted sampling in the city of Tanga in northern Tanzania. Data were collected in February and March of 2022. We report 12-month rates of road traffic crashes and RTI (reported by adult caregivers) among children and adolescents <18 years of age. RESULTS A total of 2,794 adult respondents reported data on 6563 children and adolescents, among whom, 180 were reported to have experienced road traffic crashes in the past 12 months (crash incidence: 27.4 per 1,000 children, 95%CI 23.5-31.4) and 158 sustained injuries (RTI incidence: 24.1 per 1000 children, 95%CI 20.4-27.8). Almost a quarter of RTI (23%) were reported to be major (resulting in ≥30 days of missed activities). RTI was higher among adolescents (13-17 years) than children <5 years (21.5 vs. 14.1 per 1,000, p=0.039). Few children always or sometimes wore helmets when riding on motorcycles/motorbikes (12.8%) or wore safety restraints/seat belts in cars or other vehicles (11.9%). CONCLUSION The high rate of road traffic crashes and RTI observed among children and adolescents in a medium-sized city in Tanzania underscores the urgent need to improve road safety and increase use of safety equipment in low resource settings.
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Agoston AM, Bhatia A, Bleacher JC, Smith A, Hill K, Edwards S, Cochran A, Routly M. PTSD Risk Factors and Acute Pain Intensity Predict Length of Hospital Stay in Youth after Unintentional Injury. CHILDREN 2022; 9:children9081222. [PMID: 36010111 PMCID: PMC9406594 DOI: 10.3390/children9081222] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/02/2022] [Revised: 07/27/2022] [Accepted: 08/09/2022] [Indexed: 11/16/2022]
Abstract
Background: Many hospitals have adopted screening tools to assess risk for posttraumatic stress disorder (PTSD) after pediatric unintentional injury in accordance with American College of Surgeons recommendations. The Screening Tool for Early Predictors of PTSD (STEPP) is a measure initially developed to identify youth and parents at high risk for meeting diagnostic criteria for PTSD after injury. Acute pain during hospitalization has also been examined as a potential predictor of maladaptive outcomes after injury, including PTSD. We investigated in a retrospective cohort study whether the STEPP, as well as acute pain intensity during hospitalization, would predict maladaptive outcomes during the peri-trauma in addition to the post-trauma period, specifically length of hospitalization. Methods: A total of 1123 youths aged 8–17 (61% male) and their parents were included. Patients and parents were administered the STEPP for clinical reasons while hospitalized. Acute pain intensity and length of stay were collected through retrospective chart review. Results: Adjusting for demographics and injury severity, child but not parent STEPP total predicted length of stay. Acute pain intensity, child threat to life appraisal, and child pulse rate predicted length of stay. Conclusions: Acute pain intensity and child PTSD risk factors, most notably child threat to life appraisal, predicted hospitalization length above and beyond multiple factors, including injury severity. Pain intensity and child appraisals may not only serve as early warning signs for maladaptive outcomes after injury but also indicate a more difficult trajectory during hospitalization. Additional assessment and treatment of these factors may be critical while youth are hospitalized. Utilizing psychology services to support youth and integrating trauma-informed care practices during hospitalization may support improved outcomes for youth experiencing unintentional injury.
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Affiliation(s)
- Anna Monica Agoston
- Center for Pain Relief, Children’s Healthcare of Atlanta, Atlanta, GA 30322, USA
- Division of Pediatric Anesthesiology, Emory University, Atlanta, GA 30322, USA
- Correspondence: ; Tel.: +1-503-830-4305; Fax: +1-404-785-6223
| | - Amina Bhatia
- Division of Surgery, Emory University, Atlanta, GA 30322, USA
| | - John C. Bleacher
- Division of Trauma Services, Children’s Healthcare of Atlanta, Atlanta, GA 30322, USA
| | - Alexis Smith
- Division of Trauma Services, Children’s Healthcare of Atlanta, Atlanta, GA 30322, USA
| | - Karen Hill
- Division of Trauma Services, Children’s Healthcare of Atlanta, Atlanta, GA 30322, USA
| | - Susanne Edwards
- Division of Trauma Services, Children’s Healthcare of Atlanta, Atlanta, GA 30322, USA
| | - Alicia Cochran
- Division of Trauma Services, Children’s Healthcare of Atlanta, Atlanta, GA 30322, USA
| | - Maia Routly
- Division of Trauma Services, Children’s Healthcare of Atlanta, Atlanta, GA 30322, USA
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Wang X, Li X, Qi M, Hu X, Zhu H, Shi X. Incidence of post-traumatic stress disorder in survivors of traumatic fracture: a systematic review and meta-analysis. PSYCHOL HEALTH MED 2021; 27:902-916. [PMID: 34313497 DOI: 10.1080/13548506.2021.1957953] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Post-traumatic stress disorder (PTSD) is prevalent in traumatic events. It is a great hazard of physical and mental health due to their severity and frequency. Traumatic fractures are one of the major causes of PTSD. The incidence of traumatic fractures has been high in recent years, which will directly or indirectly result in PTSD. Our target is to estimate the pooled incidence of PTSD in fracture patients after traumatic events and to explore possible influencing factors by a meta-analysis.The systematic searches in the electronic bibliographic databases of Web of Science, ScienceDirect, Ovid MEDLINE, PubMed, CNKI (China National Knowledge Infrastructure), Wangfang , and Veipu Databases. Not only were heterogeneity and 95% confidence interval (CI) used for comprehensive assessing each pooled, but also was the P value. Subgroup analyses for some sample characteristics were calculated the pooled incidence of PTSD among patients suffered from fractures.In total, 2619 patients suffered from fracture, and were assessed PTSD in the 12 eligible studies. The heterogeneity was not low (I2 = 97.6%, P < 0.001) in the 12 eligible studies. The pooled incidence of PTSD in fracture patients was 29% (95% CI, 20% to 39%) using random-effects model. Subgroup analyses revealed that the pooled incidence of PTSD among patients after traumatic fracture was statistically significant differences according to the study design, the study location, tools to assess the symptoms of PTSD, the mean age and injury mechanism (all P < 0.001). Fracture sites, injury mechanism and pain were the main influencing factors of PTSD in fracture patients.Our results highlight the phenomenon that high incidence of PTSD in patients after fracture and they should be followed up regularly and be provided effective interventions. Future efforts to improve and control the main influencing factors of PTSD for this population still needed.
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Affiliation(s)
- Xue Wang
- Department of Epidemiology and Health Statistics, School of Public Health, Zunyi Medical University, Zunyi, China
| | - Xiahong Li
- Department of Epidemiology and Health Statistics, School of Public Health, Zunyi Medical University, Zunyi, China
| | - Miao Qi
- Department of Epidemiology and Health Statistics, School of Public Health, Zunyi Medical University, Zunyi, China
| | - Xiuli Hu
- Department of Epidemiology and Health Statistics, School of Public Health, Zunyi Medical University, Zunyi, China
| | - Huiping Zhu
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China.,Center for Injury Research and Policy & Center for Pediatric Trauma Research, the Research Institute at Nationwide Children's Hospital, the Ohio State University College of Medicine, Columbus, USA
| | - Xiuquan Shi
- Department of Epidemiology and Health Statistics, School of Public Health, Zunyi Medical University, Zunyi, China.,Center for Injury Research and Policy & Center for Pediatric Trauma Research, the Research Institute at Nationwide Children's Hospital, the Ohio State University College of Medicine, Columbus, USA
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Direct and Inverse Correlates of Post-Traumatic Stress Disorder among School-Age Autistic Boys. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18105285. [PMID: 34065676 PMCID: PMC8155909 DOI: 10.3390/ijerph18105285] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/25/2021] [Revised: 05/10/2021] [Accepted: 05/13/2021] [Indexed: 11/17/2022]
Abstract
Young people with autism are often bullied at school, a potential direct correlate of Post-Traumatic Stress Disorder (PTSD). This may be compounded by their difficulties in social interaction. Alternately, some of these young people may develop ‘coping strategies’ against bullying that may have an inverse association with PTSD. As a vulnerable population for PTSD, a sample of 71 young males with autism were surveyed for their self-reported experiences of being bullied at school, their coping strategies for dealing with this bullying, and their own evaluations of the severity of two of the key diagnostic criteria for PTSD. Their mothers also provided a rating of the severity of the three major diagnostic criteria for autism for these boys. Over 80% of this sample had been bullied, and there was a significant direct correlation between this and PTSD score, and between their mother-rated severity of the boys’ social interaction difficulties, but also a significant inverse correlation between their coping strategies and PTSD score. There were differences in these relationships according to whether the boys attended elementary or secondary school. These findings hold implications for the identification, assessment and support of autistic youth at risk of PTSD.
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Yoshino M, Ueda T, Takada H, Kanno A, Maeda M, Matsumoto H, Matsui Y, Asano T, Itoh Y. Post-traumatic stress disorder of children with traffic accidents and their parents in Japan. J NIPPON MED SCH 2021; 89:47-55. [PMID: 33692302 DOI: 10.1272/jnms.jnms.2022_89-105] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
BACKGROUND Children who survive traffic accidents, and their parents, may develop post-traumatic stress disorder (PTSD) or related symptoms (depression or anxiety), which can hinder the children's development and the parents' ability to provide effective care. In Japan, the PTSD incidence rate following traffic accidents and its related factors remain unclarified. METHOD Participants were 79 children and 104 parents. The children were aged 3-18 years when injured. From August-December 2015, participants completed a self-reported questionnaire survey that comprised the 15-item Post-traumatic Stress Symptoms for Children and the Japanese version of the Impact of Event Scale-Revised. The children's Injury Severity Score (ISS) was also obtained from their medical records. Correlations, analyses of variance, and multiple regression analyses were conducted. RESULTS Among the children and the parents, 10.2% and 22.1% were deemed to be at high risk of PTSD, respectively. Their stress scores were significantly positively correlated with each other and negatively correlated with children's age at the time of the accident. Parents who witnessed their children's accidents and those whose children were hospitalized were more stressed. Neither the children's nor the parents' risk for PTSD was associated with the ISS and the amount of time since the accident. CONCLUSIONS A system that simultaneously works with children and parents, to support both parties' psychological recovery is required. To ensure psychological care post-injury, it is necessary to evaluate PTSD risk, regardless of injury severity. Implementing preventive and early interventions can prove more valuable than awaiting natural recovery.
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Affiliation(s)
- Mio Yoshino
- Department of Pediatrics, Nippon Medical School
| | | | - Haruki Takada
- Department of Clinical Psychology, Faculty of Psychology, Iryo Sosei University
| | - Aya Kanno
- Department of Pediatrics, Nippon Medical School Chiba Hokusoh Hospital
| | - Miho Maeda
- Department of Pediatrics, Nippon Medical School.,Department of Pediatric Dentistry, School of Life Dentistry at Tokyo, Nippon Dental University
| | - Hisashi Matsumoto
- Shock and Trauma Center, Nippon Medical School Chiba Hokusoh Hospital
| | - Yutaka Matsui
- Graduate School of Comprehensive Human Science, Tsukuba University
| | - Takeshi Asano
- Department of Pediatrics, Nippon Medical School Chiba Hokusoh Hospital
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Pengpid S, Peltzer K. Associations of serious physical injuries with posttraumatic stress and depressive symptoms: a cross-sectional survey among university students in 26 countries. BMC Psychol 2020; 8:129. [PMID: 33298173 PMCID: PMC7727178 DOI: 10.1186/s40359-020-00501-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Accepted: 12/04/2020] [Indexed: 11/27/2022] Open
Abstract
Background Evidence of the relationship between serious physical injury and poor mental health among university students from low- and middle-income countries is limited. The aim of the study is to assess the association between serious physical injury and posttraumatic stress disorder (PTSD) and depressive symptoms in university students from low- and middle-income countries.
Methods In a cross-sectional survey, 18,382 university students from 26 countries responded to a short screening scale for DSM-IV PTSD, Center for Epidemiologic Studies Depression Scale as well as questions on injury and sociodemographics. Results The overall prevalence of past 12-month serious physical injury was 24.7%. In adjusted logistic regression analysis, compared to having no past 12-month serious physical injury, having a past 12-month serious injury was associated with 1.35 (95% CI 1.18, 1.56) times higher odds for PTSD symptoms and 1.49 (95% CI 1.32, 1.67) times higher odds for depressive symptoms in university students. Conclusion Compared to students who had not sustained a serious physical injury in the past 12 months, students with an injury had significantly higher PTSD and depressive symptoms. Mental health support of students who sustained physical injuries may prevent PTSD and depressive symptoms.
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Affiliation(s)
- Supa Pengpid
- ASEAN Institute for Health Development, Mahidol University, Salaya, Phutthamonthon, Nakhon Pathom, Thailand.,Department of Research Administration and Development, University of Limpopo, Turfloop, Mankweng, South Africa
| | - Karl Peltzer
- Department of Psychology, University of the Free State, Bloemfontein, South Africa.
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12
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Azami-Aghdash S. Meta-synthesis of qualitative evidence in road traffic injury prevention: a scoping review of qualitative studies (2000 to 2019). Arch Public Health 2020; 78:110. [PMID: 33292547 PMCID: PMC7607842 DOI: 10.1186/s13690-020-00493-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Accepted: 10/21/2020] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND A considerable number of qualitative studies have been published in recent years on the issues that the quantitative studies have limitations on. This study aimed at performing a meta-synthesis on qualitative studies on Road Traffic Injuries (RTIs) with a scoping review approach. METHODS This meta-synthesis study was conducted as a scoping review in 2019. The Arkesy and O'Malley framework was applied which has six steps of identifying the research question, identifying the relevant studies, selecting the studies, charting the data, data analysis and reporting the results, and consultation exercise. The required data were gathered by searching the relevant keywords in databases of PubMed, web of knowledge, Scopus, Cochrane Library, Science Direct, Google scholar, Sid, IranMedex. Extracted data were analyzed by the Content-Analysis method. RESULTS Finally, 30 studies were included. Extracted data summarized in five main themes and 17 sub-themes. The main themes were: consequences (individual, family, social, financial), the needs of survivors (social support and healthcare), risk factors (general risk factors, risk factors for motorcyclists, risk factors for children and adolescents), barriers of prevention (general barriers, pre-hospital barriers, emergency, and hospital barriers), and prevention solutions (increasing safety, rules and regulations, education, increasing equipment, scientific solutions) of RTIs. CONCLUSION This study combined the methods of the scoping review and the meta-synthesis to mapping all qualitative studies on the RTIs, with this approach, this study provides extensive and practical information for policy-makers, managers, practitioners, and researchers in the field of RTIs. Also, by applying this approach, the gaps in the existing knowledge and areas in need of further research are identified.
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Affiliation(s)
- Saber Azami-Aghdash
- Research Center for Evidence Based Medicine, Tabriz University of Medical Sciences, Tabriz, Iran.
- Tabriz Health Services Management Research Center, Health Management and Safety Promotion Research Institute, Tabriz University of Medical Sciences, Tabriz, Iran.
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Iljazi A, Ashina H, Al-Khazali HM, Ashina M, Schytz HW, Ashina S. Post-traumatic stress disorder attributed to traumatic brain injury in children - a systematic review. Brain Inj 2020; 34:857-863. [PMID: 32501734 DOI: 10.1080/02699052.2020.1764104] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
OBJECTIVE To assess the proportion of pediatric patients who develop post-traumatic stress disorder (PTSD) attributed to traumatic brain injury (TBI). METHODS PubMed and Embase were searched from database inception until January 26, 2019. Two independent investigators screened titles, abstracts, and subsequently, full-text articles. Following this, the same investigators also extracted data relevant for the scope of this review. RESULTS Ten articles were included in this review. In these, six unique cohorts were described, with relative frequencies of PTSD attributed TBI ranging from 3.3% to 48.5%. Two studies also found that PTSD was more common in children after TBI compared to pediatric orthopedic controls. Study quality was determined as high or very high for all six included cohorts, although the studies differed considerably in terms of methodology. CONCLUSIONS Methodological variations confound comparisons of relative frequency assessments of PTSD attributed to TBI. However, PTSD is associated with considerable long-term disability and undetected PTSD in children should raise public concern. Thus, large scale, prospective studies are needed to ascertain the clinical course of PTSD attributed to TBI in children and adolescence.
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Affiliation(s)
- Afrim Iljazi
- Danish Headache Center, Department of Neurology, Rigshospitalet Glostrup, Faculty of Health and Medical Sciences, University of Copenhagen , Copenhagen, Denmark.,BIDMC Comprehensive Headache Center.,Department of Anesthesia, Critical Care and Pain Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School , Boston, MA, USA
| | - Håkan Ashina
- Danish Headache Center, Department of Neurology, Rigshospitalet Glostrup, Faculty of Health and Medical Sciences, University of Copenhagen , Copenhagen, Denmark
| | - Haidar Muhsen Al-Khazali
- Danish Headache Center, Department of Neurology, Rigshospitalet Glostrup, Faculty of Health and Medical Sciences, University of Copenhagen , Copenhagen, Denmark
| | - Messoud Ashina
- Danish Headache Center, Department of Neurology, Rigshospitalet Glostrup, Faculty of Health and Medical Sciences, University of Copenhagen , Copenhagen, Denmark
| | - Henrik Winther Schytz
- Danish Headache Center, Department of Neurology, Rigshospitalet Glostrup, Faculty of Health and Medical Sciences, University of Copenhagen , Copenhagen, Denmark
| | - Sait Ashina
- BIDMC Comprehensive Headache Center.,Department of Neurology.,Department of Anesthesia, Critical Care and Pain Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School , Boston, MA, USA.,Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen , Copenhagen, Denmark
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14
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Serious physical injury and depressive symptoms among adolescents aged 12-15 years from 21 low- and middle-income countries. J Affect Disord 2020; 264:172-180. [PMID: 32056747 DOI: 10.1016/j.jad.2019.12.026] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2019] [Revised: 12/08/2019] [Accepted: 12/14/2019] [Indexed: 12/17/2022]
Abstract
BACKGROUND Little is known about the relationship between physical injury and depression in youths from low- and middle-income countries (LMICs). Therefore, the aim of this study was to analyze the association between serious physical injury and depressive symptoms among adolescents in 21 LMICs. METHODS Data from the Global School-based Student Health Survey (2003-2008) were analyzed. Serious physical injury and depressive symptoms in the past 12 months were assessed with self-report measures. The association between serious physical injury and depressive symptoms was examined using multivariable logistic regression analysis and meta-analysis. RESULTS The final sample consisted of 44,333 adolescents aged 12-15 years. After adjustment for sex, age, food insecurity, alcohol consumption, and country, an increasing number of serious physical injuries in the past 12 months was associated with increments in the odds for depressive symptoms in a dose-dependent fashion. Those who had ≥6 serious injuries (vs. no injuries) were 2.79 (95%CI=2.23-3.48) times more likely to have depressive symptoms. The pooled odds ratio (OR) (95%CI) for the association between at least one serious physical injury and depressive symptoms obtained by meta-analysis based on country-wise estimates was 1.83 (1.67-2.01) with a moderate level of between-country heterogeneity (I2=56.0%). LIMITATIONS This was a cross-sectional study and causality of the association cannot be deduced. CONCLUSIONS Serious physical injury may be a risk factor for depressive symptoms among adolescents in LMICs. Efforts to prevent physical injury and the provision of adequate health care for those who are injured may improve mental wellbeing among adolescents in this setting.
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Azevedo H, Ferreira M, Mascarello A, Osten P, Werneck Guimarães CR. The serotonergic and alpha-1 adrenergic receptor modulator ACH-000029 ameliorates anxiety-like behavior in a post-traumatic stress disorder model. Neuropharmacology 2019; 164:107912. [PMID: 31843397 DOI: 10.1016/j.neuropharm.2019.107912] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2019] [Revised: 12/06/2019] [Accepted: 12/11/2019] [Indexed: 01/17/2023]
Abstract
Post-traumatic stress disorder (PTSD) is a severe chronic mental illness that develops in individuals exposed to life-threatening trauma and is characterized by hyperarousal, flashbacks and nightmares. The serotonergic (5-HT) and noradrenergic (NE) systems are deeply involved in the pathogenesis of PTSD. We have previously reported a novel anxiolytic compound, ACH-000029, that modulates 5-HT and α1-adrenergic receptors and induces acute anxiolytic-like effects in rodents. Here, we investigated the potential of ACH-000029 to prevent anxiety-like behavior in the single prolonged stress (SPS) PTSD model. Mice were subjected to the SPS procedure, followed by a 7-day treatment with ACH-000029 and, for comparison, with the α1-adrenergic antagonist prazosin. Animals were behaviorally assessed using social interaction, elevated plus maze and open field tests. Interestingly, treatment with ACH-000029 but not with prazosin ameliorated the SPS-induced sociability impairment and anxiety-like behavior. The brain-wide c-fos mapping, used as a surrogate for brain activity, indicated the brain structures that were altered by SPS and putatively involved in the anxiolytic-like effect of ACH-000029. The SPS protocol produced long-lasting impairment of regions involved in stress-anxiety response, such as the amygdala, prefrontal cortex, globus pallidus and superior colliculus. ACH-000029 treatment reversed the SPS-induced c-fos changes in the globus pallidus, lateral septum and entorhinal cortex and exclusively modulated c-fos levels in subregions from the retrosplenial cortex, cerebellum, superior colliculus and ventromedial hypothalamus. These results support the hypothesis that the dual regulation of 5-HT and α1-adrenergic receptors is required to alleviate PTSD symptoms and suggest a possible role of ACH-000029 as a PTSD treatment.
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Affiliation(s)
- Hatylas Azevedo
- Aché Laboratórios Farmacêuticos, Guarulhos, São Paulo, Brazil.
| | - Marcos Ferreira
- Aché Laboratórios Farmacêuticos, Guarulhos, São Paulo, Brazil
| | | | - Pavel Osten
- Cold Spring Harbor Laboratories, Cold Spring Harbor, NY, USA; Certerra, Inc., Cold Spring Harbor, NY, USA
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Homma H, Okada M, Nakauchi A, Osawa E, Nagai N, Sakurai A, Shintani S. Treatment of Child with Four Lost Maxillary Incisors due to Traffic Injury. THE BULLETIN OF TOKYO DENTAL COLLEGE 2019; 60:211-220. [DOI: 10.2209/tdcpublication.2018-0062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Hiromi Homma
- Department of Pediatric Dentistry, Tokyo Dental College
| | | | | | - Eri Osawa
- Department of Pediatric Dentistry, Tokyo Dental College
| | - Nobuko Nagai
- Department of Pediatric Dentistry, Tokyo Dental College
| | - Atsuo Sakurai
- Department of Pediatric Dentistry, Tokyo Dental College
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