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Radow B, Anderson N, Richmond BK. Post-Traumatic Stress Disorder (PTSD) in Trauma Patients. Am Surg 2024:31348241290610. [PMID: 39383492 DOI: 10.1177/00031348241290610] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/11/2024]
Abstract
Post-traumatic stress disorder (PTSD) was first introduced as a diagnosis by the American Psychiatric Association in 1980. This diagnosis, included in the 3rd edition of the Diagnostic and Statistical Manual of the American Psychiatric Association (DSM-III), was to be considered after someone was exposed to a traumatic event "outside the range of usual human experience and would be markedly distressing to almost anyone." Since then, trauma survivors have been identified as being at risk for the development of post-traumatic stress symptom (PTSS) and post-traumatic stress disorder (PTSD). Despite the recognition of this fact, the screening, recognition, and diagnosis of PTSD in these at-risk populations are inconsistent. In the following review, which is designed for the clinician who is unfamiliar with PTSD and its recognition, diagnosis, and treatment, we introduce the problem in the trauma patient and define its scope. In addition, we discuss the diagnosis of PTSD in trauma patients, special considerations relating to these patient populations, treatment options, and explore future directions for how best to define, study, recognize, and treat this challenging and potentially devastating condition.
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Affiliation(s)
- Brandon Radow
- Department of Surgery, CAMC Institute for Academic Medicine, Charleston Area Medical Center, Charleston, WV, USA
| | - Nathaniel Anderson
- Department of Surgery, CAMC Institute for Academic Medicine, Charleston Area Medical Center, Charleston, WV, USA
| | - Bryan K Richmond
- Department of Surgery, CAMC Institute for Academic Medicine, Charleston Area Medical Center, Charleston, WV, USA
- Department of Surgery, West Virginia University Charleston, Charleston, WV, USA
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Chambre A, Outh-Gauer S, Tuchtan L, Delannoy Y, Laugier V, Bourokba N, Martrille L, Macaigne C, Savall F, Lefevre T. Evaluating the Functional Impairment of Assault Victims in a Judicial Context: A Multicentered Retrospective Study in Seven French Forensics Units. JOURNAL OF INTERPERSONAL VIOLENCE 2024:8862605241268764. [PMID: 39099172 DOI: 10.1177/08862605241268764] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/06/2024]
Abstract
Functional impairment is of major importance in the evaluation of assault victims. French law assesses the seriousness of the violence in terms of the functional impairment experienced by the victims, quantified by the duration of the victims' inability to fulfill their usual daily activities, measured in days of "total incapacity to work" (TIW). Significant variations in the duration of TIW have been reported depending on the examination centers or physician. To date, few studies, all monocentric, have focused on the determinants of this variability. We aimed to study the functional impairment of assault victims by searching for determinants of TIW. We conducted a retrospective multicenter study, including assault victims from seven forensic medicine units. The data were automatically extracted from the medical certificates drawn up and gathered within the ORFéAD database. Thirty-eight variables were studied, relating to the victim's characteristics, the circumstances of the examination and the assault, the physical and psychological symptoms, and the duration of TIW. A total of 5,663 victims were included, including 2,438 (43%) women. The median age was 32 years (min; max [10; 98]). The median duration of TIW was 2 days (min; max [0; 182]). Male gender, age, time to examination, examination center, traumatic injuries (ecchymosis, hematoma, wound, bone fracture), use of a weapon, and functional limitation were associated with the duration of TIW (p < .05). The associations formerly identified in a monocentric setting were confirmed and new determinants were identified. This study has allowed a better understanding of the factors influencing the evaluation of functional impairment and determination of the TIW of assault victims. This first study using ORféAD is intended to be supplemented by the participation of other forensic units, and the inclusion of other variables, such as violence type, victim categories, or the examining physician.
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Affiliation(s)
- Arthur Chambre
- Centre Hospitalier Sud Francilien, Corbeil-Essonnes, France
| | | | | | - Yann Delannoy
- CHU Lille, Lille, France
- Université Lille ULR 7367-UTML and A-Unité de Taphonomie Médico-Légale & d'Anatomie, F-Lille, France
| | | | | | | | - Cyrus Macaigne
- Centre Hospitalier Intercommunal de Créteil, Créteil, France
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Aydogdu HI, Koca Y, Cirakoglu E, Anolay NN. Is post-traumatic stress disorder related to the severity of physical trauma? REVISTA DA ASSOCIACAO MEDICA BRASILEIRA (1992) 2023; 69:e20230439. [PMID: 37729370 PMCID: PMC10508949 DOI: 10.1590/1806-9282.20230439] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Accepted: 05/27/2023] [Indexed: 09/22/2023]
Abstract
OBJECTIVE Trauma can cause physical morbidity and even result in death. Besides, it can lead to serious mental problems as well. The most well-known mental health problem is post-traumatic stress disorder. Through this study, it was primarily aimed to find out whether the severity of physical trauma is effective on post-traumatic stress disorder and other risk factors if any. METHODS The reports of the patients who were transferred to the Turkish Council of Forensic Medicine Third Speciality Board between January 01, 2019, and December 31, 2020, for post-traumatic invalidity or disability evaluation and whose psychiatric examinations were performed were retrospectively analyzed in the electronic environment. RESULTS It was found that 34 (26.4%) of the patients had a diagnosis of post-traumatic stress disorder (under treatment for at least 6 months), while 76 (58.9%) of them did not have a psychiatric disease and 19 (14.7%) of them had mental disorders not associated with trauma (i.e., affective disorder, anxiety disorder, etc.). No significant correlation was found between trauma scores and post-traumatic stress disorder (p>0.05). CONCLUSION Based on the results of our study, post-traumatic stress disorder and the severity of physical trauma are not significantly correlated. Being of female gender, sustaining a non-accidental injury, and witnessing a fatal event stand out as significant risk factors.
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Affiliation(s)
- Halil Ilhan Aydogdu
- Giresun University, Faculty of Medicine, Department of Forensic Medicine – Giresun, Turkey
| | - Yasin Koca
- The Ministry of Justice Council of Forensic Medicine – Istanbul, Turkey
| | - Emre Cirakoglu
- The Ministry of Justice Council of Forensic Medicine – Istanbul, Turkey
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Worku A, Tesfaw G, Getnet B. Acute stress disorder and the associated factors among traumatized patients admitted at Felege-Hiwot and the University of Gondar comprehensive specialized hospitals in Northwest Ethiopia. BMC Psychiatry 2022; 22:309. [PMID: 35501782 PMCID: PMC9059423 DOI: 10.1186/s12888-022-03961-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Accepted: 04/27/2022] [Indexed: 12/01/2022] Open
Abstract
BACKGROUND Acute stress disorder is the main factor of impairment in multiple areas of functioning that affects almost all age groups and which also influences mental and physical health. However, it negatively impacts the quality of life and social activities. The empirical evidence about probable acute stress disorder (ASD) and its associated factors is not available in Ethiopia to date. Therefore, the present study was aimed at identifying the magnitude and associated factors of probable ASD among traumatized patients in order to plan and render informed intervention for these vulnerable people. METHODS An institutional-based cross-sectional study was conducted at Felege-Hiwot and the University of Gondar comprehensive specialized hospitals from March 11/2020 to April 20/2020, by using a structured and semi-structured questionnaire. Systematic random sampling was used to recruit a total of 422 patients. The standard acute stress disorder scale was used to identify the prevalence of acute stress disorder by employing a face-to-face interview. Bivariate and multivariate logistic regression analysis was used to identify associated factors with probable acute stress disorder. Statistical significance was declared on 95% of confidence intervals (CI) at P < 0.05. RESULTS The prevalence of probable acute stress disorder was found to be 45% (95% CI: 40.2 to 49.6). In the multivariate logistic analysis; exposure to past history of trauma (AOR = 3.46, 95%, CI: 1.01-11.80), past psychiatry illness (AOR = 3.02, 95% CI: 1.15-7.92), anxiety (AOR = 2.38, 95% CI: 1.30-4.38), poor social support (AOR = 4.07, 95% CI: 2.20-7.52) and moderate (AOR = 4.56, 95% CI:2.44-8.52), and sever perceived threat to life (AOR = 2.75, 95% CI: 1.64, 4.60) were factors significantly associated with probable acute stress disorder. CONCLUSION Findings of this study indicated that the prevalence of probable acute stress disorder among study participants exposed to multiple forms of traumatic events was considerably high. History of trauma and past psychiatric illness, poor and moderate social support, and moderate perceived stress were factors significantly associated with probable acute stress disorder. The ministry of health and other concerned health organizations may find the current finding useful for early detection, prevention, and intervention strategies to minimize the factor of acute stress disorder in trauma survivors.
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Affiliation(s)
- Asnakew Worku
- grid.59547.3a0000 0000 8539 4635University of Gondar, Gondar, Ethiopia
| | - Getachew Tesfaw
- Departments of Psychiatry, College of Medicine and Health Science, University of Gondar, P. O. Box: 196, Gondar, Ethiopia.
| | - Berhanie Getnet
- grid.59547.3a0000 0000 8539 4635Departments of Psychiatry, College of Medicine and Health Science, University of Gondar, P. O. Box: 196, Gondar, Ethiopia
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Johansen VA, Milde AM, Nilsen RM, Breivik K, Nordanger DØ, Stormark KM, Weisæth L. The Relationship Between Perceived Social Support and PTSD Symptoms After Exposure to Physical Assault: An 8 Years Longitudinal Study. JOURNAL OF INTERPERSONAL VIOLENCE 2022; 37:NP7679-NP7706. [PMID: 33140665 PMCID: PMC9092899 DOI: 10.1177/0886260520970314] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Consequences of nondomestic violence are known to be multifaceted with high rates of emotional and psychological problems in addition to physical injuries, and victims report many trauma related symptoms. This study explore if perceived social support (PSS) (Social Provisions Scale [SPS]) and post-traumatic stress disorder (PTSD) symptoms (Impact of Event Scale [IES-22]) are interrelated among adult victims at four assessment points up until eight years after the exposure to physical assault; soon after the event (T1), three months after T1 (T2), one year after T1 (T3), and eight years after T1 (T4). One hundred and forty-three subjects participated at T1, 94 at T2, 73 at T3, and 47 accepted a follow-up at T4. At T1, 138 of 143 completed the questionnaires within 16 weeks after the incident. PTSD symptoms were highly correlated across time (p < .001); PSS were significantly correlated only between T1 and T2 (p < .001), T1 and T3 (p < .05), and between T2 and T3 (p < .05). Cross-lagged analyses showed an inverse relationship between prior PSS and later PTSD symptoms across all time points (ps < .05); not proved between prior PTSD symptoms and later PSS (ps > .1). PSS at T1 was an independent predictor of PSS one year and eight years after the incident. We conclude that higher perception of social support protects against the development of PTSD symptoms; diminished perception of social support increases the risk of developing PTSD symptoms. These findings suggest that PSS after experiencing a violent assault should be considered as an important factor in natural recovery in the long run, as well as essential alongside psychiatric treatment. Establishing psychosocial interventions for victims of physical violence in the acute phase may prevent prolonged trauma reactions.
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Affiliation(s)
- Venke A Johansen
- Haukeland University Hospital, Bergen, Norway
- Western Norway University of Applied Sciences (HVL), Bergen, Norway
| | - Anne Marita Milde
- NORCE Norwegian Research Centre AS, Bergen, Norway
- University of Bergen, Norway
| | | | | | - Dag Øystein Nordanger
- Haukeland University Hospital, Bergen, Norway
- Oslo Metropolitan University, Oslo, Norway
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Ozer P, Dembele A, Yameogo SS, Hut E, de Longueville F. The impact of COVID-19 on the living and survival conditions of internally displaced persons in Burkina Faso. WORLD DEVELOPMENT PERSPECTIVES 2022; 25:100393. [PMID: 35036662 PMCID: PMC8743390 DOI: 10.1016/j.wdp.2022.100393] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Revised: 09/05/2021] [Accepted: 01/04/2022] [Indexed: 05/28/2023]
Abstract
In recent years, as in other parts of the Sahel, the threat of terrorism has escalated in Burkina Faso. In 2019, this country hosted the fourth highest number of new conflict-related internal displaced persons (IDPs) in the world. These people have to cope simultaneously with the full spectrum of environmental, social and health-related stresses in the long, medium and short term, respectively. We seek to compare the living conditions of IDPs before and during the lockdown implemented by the authorities (between 27 March and 5 May 2020) to contain the spread of the virus. Interviews were conducted with 106 IDPs in Kongoussi (Central-Northern region). Although no respondent reported having been directly affected by the virus, 84.9% of the IDPs surveyed had no income-generating activities during the lockdown and the remaining 15.1% who continued to work reported that their activities had been greatly scaled-down. For a large majority of them, their living conditions, already described as difficult under 'normal' circumstances (insufficient food, insignificant financial assistance, or difficult access to health care), further deteriorated. In addition, IDPs were unable to leave the camps or regions where they were located to search for better living conditions or to return home. Lastly, 96.2% of respondents believed that the COVID-19 pandemic would have a negative impact on their future. These IDPs, like many in the sub-region and around the world, therefore require urgent assistance from the authorities and humanitarian NGOs, as the slightest new stress is likely to considerably worsen their already vulnerable state.
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Affiliation(s)
- Pierre Ozer
- Department of Environmental Sciences and Management, UR SPHERES, University of Liège, Belgium
- The Hugo Observatory, UR SPHERES, University of Liège, Belgium
| | - Adama Dembele
- Department of Environmental Sciences and Management, UR SPHERES, University of Liège, Belgium
| | - Simplice S Yameogo
- Executive Secretariat of the National Council for Food Security, Ministry of Agriculture and Hydro Agricultural Development, Burkina Faso
| | - Elodie Hut
- The Hugo Observatory, UR SPHERES, University of Liège, Belgium
| | - Florence de Longueville
- Department of Geography, University of Namur, Belgium
- Institute of Life, Earth and Environment, University of Namur, Belgium
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Pijpers ML, Covers MLV, Houterman S, Bicanic IAE. Risk factors for PTSD diagnosis in young victims of recent sexual assault. Eur J Psychotraumatol 2022; 13:2047293. [PMID: 35401950 PMCID: PMC8986203 DOI: 10.1080/20008198.2022.2047293] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
BACKGROUND Sexual assault is associated with a high risk of developing PTSD. Little is known about the PTSD onset in children who have recently been victimized by sexual assault. It is important to identify children at risk for PTSD after sexual assault to prevent chronic problems and revictimization. OBJECTIVE The first aim of this study was to describe the development of post-traumatic stress symptoms in the four weeks after sexual assault. The second aim was to analyse whether pre-assault factors, assault-related factors, social support, and post-traumatic stress, measured at two weeks post-assault, were associated with an indication of PTSD. METHOD From January 2019 to March 2021, data were collected of victims aged 8-17 years (n = 51; mean age = 15.00; SD = 1.78) who had contacted a Sexual Assault Centre. Severity of post-traumatic stress symptoms was measured at two and four weeks post-assault. The study was designed to use a multivariate logistic regression analysis. The study included female victims only. RESULTS Most of the victims (58.8%) showed a decline in the severity of post-traumatic stress symptoms in the four weeks after sexual assault. However, 27.4% showed an increase and 13.7% showed no change in symptoms. More than two-thirds of the children (70.6%) showed severe post-traumatic stress symptoms at four weeks post-assault, i.e. had an indication of PTSD. Since only one significant difference was found, the multivariate analysis was not executed. A significant difference was found between severity of symptoms at two weeks and an indication of PTSD at four weeks (t(49) = -5.79; p < .001). CONCLUSION Children with high levels of post-traumatic stress at two weeks post-assault are at risk for PTSD indication at four weeks post-assault. Further research is needed to determine whether early trauma-based treatment for children with high post-traumatic stress symptoms can prevent the development of PTSD.
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Affiliation(s)
- Mirjam L Pijpers
- Department of Psychology, Catharina Hospital, Eindhoven, Netherlands
| | - Milou L V Covers
- National Psychotrauma Center for Children and Youth, University Medical Center Utrecht, Utrecht, Netherlands
| | - Saskia Houterman
- Department of Education and Research, Catharina Hospital, Eindhoven, the Netherlands
| | - Iva A E Bicanic
- National Psychotrauma Center for Children and Youth, University Medical Center Utrecht, Utrecht, Netherlands
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Lefebvre C, Fortin C, Guay S. Quality of Life After Violent Crime: The Impact of Acute Stress Disorder, Posttraumatic Stress Disorder, and Other Consequences. J Trauma Stress 2021; 34:526-537. [PMID: 33210388 DOI: 10.1002/jts.22623] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2020] [Revised: 07/15/2020] [Accepted: 07/21/2020] [Indexed: 11/07/2022]
Abstract
Victims of violent crime (VVC) are at risk of developing acute stress disorder (ASD) and subsequent posttraumatic stress disorder (PTSD). In addition, VVC are more likely to have low social support due to stigmatization and victim-blaming, and PTSD is frequently associated with depression, anxiety, and impaired quality of life (QoL). The present study aimed to determine the impact of ASD, PTSD, depressive symptoms, anxiety symptoms, and perceived social support in relation to four domains of QoL among VVC. Individuals were recruited as part of a longitudinal study assessing the efficacy of a brief cognitive behavioral treatment for ASD. Participants (N = 127) were interviewed and completed self-report measures within 30 days of experiencing a violent crime (T0 ) and at assessments 2 months (T1 ) and 6 months (T2 ) after the event. Depressive symptoms, ASD, and PTSD were found to be associated with lower QoL ratings in all four domains. Anxiety symptoms were found to be associated with lower ratings in the physical health and psychological QoL domains. Perceived social support was found to be associated with higher QoL ratings in all domains. The proportions of QoL variance explained by the combined fixed and random effects combined ranged from 70% to 79%. Future research considerations include an examination of how early interventions for VVC could prevent QoL deterioration by targeting ASD and PTSD development, depressive and anxiety symptoms, and social support.
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Affiliation(s)
- Chanelle Lefebvre
- Department of Psychology, University of Quebec in Montreal, Montreal, Canada.,Trauma Studies Center, Research Center of the Montreal Mental Health University Institute, Montreal, Canada
| | - Christophe Fortin
- Department of Psychology, University of Quebec in Montreal, Montreal, Canada.,School of Psychology, University of Ottawa, Ottawa, Canada.,Trauma Studies Center, Research Center of the Montreal Mental Health University Institute, Montreal, Canada
| | - Stéphane Guay
- School of Criminology, University of Montreal, Montreal, Canada.,Trauma Studies Center, Research Center of the Montreal Mental Health University Institute, Montreal, Canada
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Zalta AK, Tirone V, Orlowska D, Blais RK, Lofgreen A, Klassen B, Held P, Stevens NR, Adkins E, Dent AL. Examining moderators of the relationship between social support and self-reported PTSD symptoms: A meta-analysis. Psychol Bull 2021; 147:33-54. [PMID: 33271023 PMCID: PMC8101258 DOI: 10.1037/bul0000316] [Citation(s) in RCA: 70] [Impact Index Per Article: 23.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Social support is one of the most robust predictors of posttraumatic stress disorder (PTSD). Yet, little is known about factors that moderate the relationship between social support and PTSD symptom severity. This meta-analysis estimated the overall effect size of the relationship between self-reported social support and PTSD severity and tested meaningful demographic, social support, and trauma characteristics that may moderate this association using both cross-sectional and longitudinal effect sizes. A comprehensive search identified 139 studies with 145 independent cross-sectional effect sizes representing 62,803 individuals and 37 studies with 38 independent longitudinal effect sizes representing 25,792 individuals. Study samples had to comprise trauma-exposed, nonclinical adult populations to be included in the analysis. Cross-sectional and longitudinal analyses revealed a near medium overall effect size (rcross = -.27; 95% CI [-.30, -.24]; rlong = -.25; 95% CI [-.28, -.21]) with a high degree of heterogeneity (cross-sectional I2 = 91.6, longitudinal I2 = 86.5). Both cross-sectional and longitudinal moderator analyses revealed that study samples exposed to natural disasters had a weaker effect size than samples exposed to other trauma types (e.g., combat, interpersonal violence), studies measuring negative social reactions had a larger effect size than studies assessing other types of social support, and veteran samples revealed larger effect sizes than civilian samples. Several other methodological and substantive moderators emerged that revealed a complex relationship between social support and PTSD severity. These findings have important clinical implications for the types of social support interventions that could mitigate PTSD severity. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
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Affiliation(s)
- Alyson K. Zalta
- Department of Psychological Science, University of California, Irvine, Irvine, CA
- Department of Psychiatry & Behavioral Sciences, Rush University Medical Center, Chicago, IL
| | - Vanessa Tirone
- Department of Psychiatry & Behavioral Sciences, Rush University Medical Center, Chicago, IL
| | - Daria Orlowska
- University Libraries, Western Michigan University, Kalamazoo, MI
| | | | - Ashton Lofgreen
- Department of Psychiatry & Behavioral Sciences, Rush University Medical Center, Chicago, IL
| | - Brian Klassen
- Department of Psychiatry & Behavioral Sciences, Rush University Medical Center, Chicago, IL
| | - Philip Held
- Department of Psychiatry & Behavioral Sciences, Rush University Medical Center, Chicago, IL
| | - Natalie R. Stevens
- Department of Psychiatry & Behavioral Sciences, Rush University Medical Center, Chicago, IL
| | - Elizabeth Adkins
- Department of Preventive Medicine, Northwestern University, Chicago, IL
| | - Amy L. Dent
- Department of Psychological Science, University of California, Irvine, Irvine, CA
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Agarwal TM, Muneer M, Asim M, Awad M, Afzal Y, Al-Thani H, Alhassan A, Mollazehi M, El-Menyar A. Psychological trauma in different mechanisms of traumatic injury: A hospital-based cross-sectional study. PLoS One 2020; 15:e0242849. [PMID: 33253298 PMCID: PMC7703890 DOI: 10.1371/journal.pone.0242849] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2020] [Accepted: 11/10/2020] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Psychological distress following traumatic injury can influence the patient health, well-being and quality of life; however, this impact may partly vary according to the type and severity of injury. We aimed to study the predominant distress causing cluster and individual symptoms of Post-Traumatic Stress Disorders (PTSD) at the clinical and subthreshold level in patients with traumatic injuries, based on the mechanism of injury (MOI). METHODS A hospital based cross-sectional study was conducted at a Level 1 Trauma Center utilizing PTSD Checklist to diagnose PTSD after one month of the traumatic event. All patients suffering from psychological distresses were assessed by a clinical psychologist in the trauma section. PTSD diagnostic criteria from DSM-5 were used to classify the patients. The inclusion criteria comprised of adult trauma patients who were directly involved in traumatic injuries and admitted under the Trauma Surgery services for a minimum of one day; have ability to provide written informed consent and can be assessed with the PCL-5 checklist after 4 weeks post-injury. RESULTS Two hundred patients completed PCL-5 checklist, of them 26 (13.0%) were positive for PTSD and 174 (87%) had subthreshold scores. The mean age of participants was 34.4±11.8 years and males constituted 90.5%. Road traffic injury (RTI) was most the frequent injury mechanism (59%). PTSD positive patients with RTI, fall of heavy objects, pedestrian injury and assaults had highest average scores on clusters of negative alterations in mood and cognitions (16.9, 18.0, 18.5, 17.0 respectively), followed by hyperarousal. Symptom of always being on the guard and having repeated unwanted or disturbing memories of the incident, was reported by nearly 100% PTSD positive patients. Patients with subthreshold scores also reported distressing symptoms on all four clusters of PTSD. CONCLUSIONS Patients with different MOI showed a broad range of psychological problems with respect to symptom clusters. Negative alteration in mood and cognition followed by hyperarousal caused higher level of distress in patients post traumatic injuries. Subthreshold symptoms of PTSD are more common and deserve more attention.
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Affiliation(s)
| | - Mohammed Muneer
- Department of Surgery, Plastic Surgery, Hamad Medical Corporation, Doha, Qatar
| | - Mohammad Asim
- Clinical Research, Trauma & Vascular Surgery, Department of Surgery, Hamad General Hospital, Doha, Qatar
| | - Malaz Awad
- Medical Research Center, Hamad Medical Corporation, Doha, Qatar
| | - Yousra Afzal
- Medical Research Center, Hamad Medical Corporation, Doha, Qatar
| | - Hassan Al-Thani
- Department of Surgery, Trauma Surgery, Hamad General Hospital, Doha, Qatar
| | - Ahmed Alhassan
- Department of Psychiatry, Hamad Medical Corporation, Doha, Qatar
| | - Monira Mollazehi
- Department of Surgery, Trauma Surgery, Hamad General Hospital, Doha, Qatar
| | - Ayman El-Menyar
- Clinical Research, Trauma & Vascular Surgery, Department of Surgery, Hamad General Hospital, Doha, Qatar
- Department of Clinical Medicine, Weill Cornell Medical School, Doha, Qatar
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Boisclair Demarble J, Fortin C, D'Antono B, Guay S. Gender Differences in the Prediction of Acute Stress Disorder From Peritraumatic Dissociation and Distress Among Victims of Violent Crimes. JOURNAL OF INTERPERSONAL VIOLENCE 2020; 35:1229-1250. [PMID: 29294663 DOI: 10.1177/0886260517693000] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Peritraumatic dissociation and distress are strong predictors of acute stress disorder (ASD) and posttraumatic stress disorder (PTSD) development. However, there is limited data concerning gender differences in these relations, particularly among victims of violent crimes (VVC). The objective of this study is to examine whether peritraumatic dissociation and distress predict the number of ASD symptoms differently for men and women VVC. In all, 162 adults (97 women, M age = 39.6 years), 63% of whom experienced physical assaults, completed the Acute Stress Disorder Interview, the Peritraumatic Dissociative Experience Questionnaire, and the Peritraumatic Distress Inventory. Analyses included t tests and multiple hierarchical regressions models controlling for known PTSD risk factors. The regression model showed dissociation and distress to be significant predictors of ASD for both men and women (β = .349 and β =.312 respectively; all p < .001). A significant three-way interaction was also observed between peritraumatic distress (PDI), past potentially traumatic experiences, and gender. In simple slopes analyses, the combination of high levels of PDI and of a high number of past potentially traumatic events were associated with greater risk of ASD in men only (b = 3.78, p < .001). However, women experienced greater PDI, t(157) = 5.844, p = .005, than men, and elevated distress was associated with more ASD symptoms independently of past traumatic events. Gender differences were revealed as a function of past potentially traumatic experiences. There is a cumulative impact of past potential traumas and current distress that predicts ASD in men, while in women, it contributes to ASD via increased distress.
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Affiliation(s)
- Julie Boisclair Demarble
- Department of Psychology, Université de Montreal, Québec, Canada
- Institut Universitaire en Santé Mentale de Montreal, Montreal, Quebec, Canada
| | - Christophe Fortin
- Trauma Studies Center, Institut Universitaire en Santé Mentale de Montreal
- Department of Psychology, Université d'Ottawa, Ottawa, Canada
| | - Bianca D'Antono
- Department of Psychology, Université de Montreal, Québec, Canada
- Research Center, Montreal Heart Institute, Montreal, Quebec, Canada
| | - Stéphane Guay
- Trauma Studies Center, Institut Universitaire en Santé Mentale de Montreal
- School of Criminology, Université de Montreal, Québec, Canada
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Gilmore AK, Flanagan JC. Acute mental health symptoms among individuals receiving a sexual assault medical forensic exam: the role of previous intimate partner violence victimization. Arch Womens Ment Health 2020; 23:81-89. [PMID: 30762148 PMCID: PMC6733667 DOI: 10.1007/s00737-019-0947-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2018] [Accepted: 01/28/2019] [Indexed: 01/02/2023]
Abstract
Sexual assault and intimate partner violence (IPV) are common in the USA, and they often co-occur. Individuals with multiple victimization experiences have more severe mental health outcomes compared to those with one victimization. The current study examined mental health symptoms and their association with IPV victimization history among a sample of individuals who experienced a recent sexual assault and received a sexual assault medical forensic examination. A total of 82 participants (92.70% female) completed a post-sexual assault survey as part of clinical care to coordinate follow-up services. IPV history and prior sexual assault were assessed as well as mental health symptoms including acute stress and depressive symptoms. It was found that individuals with an IPV history reported more acute stress and depressive symptoms compared to those without an IPV history. No differences were found based on prior sexual assault history. These findings highlight the importance of screening for IPV history during the sexual assault medical forensic examination to coordinate care.
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Affiliation(s)
- Amanda K Gilmore
- College of Nursing, Medical University of South Carolina, Charleston, SC, USA.
- Department of Psychiatry & Behavioral Sciences, Medical University of South Carolina, Charleston, SC, USA.
| | - Julianne C Flanagan
- Department of Psychiatry & Behavioral Sciences, Medical University of South Carolina, Charleston, SC, USA
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13
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Odachowska E, Trzebiński J, Prusik M. The Impact of Self-Narrative Framing of a Close Person’s Sudden Death on Coping With the Meaning in Life. JOURNAL OF LOSS & TRAUMA 2019. [DOI: 10.1080/15325024.2019.1565145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
| | - Jerzy Trzebiński
- SWPS University of Social Sciences and Humanities, Warsaw, Poland
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14
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Guay S, Sader J, Boyer R, Marchand A. Treatment of acute stress disorder for victims of violent crime. J Affect Disord 2018; 241:15-21. [PMID: 30089232 DOI: 10.1016/j.jad.2018.07.048] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2018] [Revised: 06/08/2018] [Accepted: 07/17/2018] [Indexed: 12/31/2022]
Abstract
BACKGROUND Victims of violent crime are at elevated risk of developing acute stress disorder (ASD) as well as subsequent post-traumatic stress disorder (PTSD), both of which are linked to severe psychological distress. The aim of this 12-month prospective study was to evaluate the efficacy of cognitive-behavioral therapy (CBT) vs. cognitive-behavioral therapy with a significant other (CBT-SO), relative to usual care (UC), for the improvement of post-traumatic, depression and anxiety symptoms and the prevention of PTSD among victims of violent crime with ASD. METHODS A total of 166 victims of violent crime with ASD were assigned to CBT (n = 54), CBT-SO (n = 52) or UC (n = 60). Self-report assessments and diagnostic interviews were completed at pre-treatment and post-treatment as well as at 6-month and 12-month follow-ups. RESULTS CBT and CBT-SO participants had fewer depression symptoms than those in the UC group up to 12 months post-event. Significantly fewer participants in the CBT condition met criteria for PTSD than in the UC group up to 12 months post-event. The CBT group did not differ from the CBT-SO group on any variable at any assessment time. LIMITATIONS Findings must be interpreted in light of the quasi-experimental nature of the study and limitations concerning the management of missing data. CONCLUSIONS Further research is warranted in order to assess whether more extensive involvement of a significant other in therapy may lead to better outcomes for victims of violent crime with ASD.
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Affiliation(s)
- Stéphane Guay
- School of Criminology, University of Montreal, Montreal, Canada; Department of Psychiatry, University of Montreal, Montreal, Canada.
| | - Josette Sader
- School of Criminology, University of Montreal, Montreal, Canada
| | - Richard Boyer
- Department of Psychiatry, University of Montreal, Montreal, Canada
| | - André Marchand
- Department of Psychology, University of Quebec in Montreal, Montreal, Canada
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15
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Ophuis RH, Olij BF, Polinder S, Haagsma JA. Prevalence of post-traumatic stress disorder, acute stress disorder and depression following violence related injury treated at the emergency department: a systematic review. BMC Psychiatry 2018; 18:311. [PMID: 30253782 PMCID: PMC6156976 DOI: 10.1186/s12888-018-1890-9] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2017] [Accepted: 09/17/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND In order to gain insight into the health impact of violence related injury, the psychological consequences should be taken into account. There has been uncertainty regarding the prevalence of posttraumatic stress disorder (PTSD), acute stress disorder (ASD), and depression among patients with violence related injury. An overview of prevalence rates may inform our understanding of both prognosis and recovery for these patients. Therefore, we aim to provide an overview of the published literature reporting the prevalence rates and trajectories of PTSD, ASD, and depression following violence related injury, and to assess the quality of the studies included. METHODS A systematic review was conducted in order to provide an overview of the published literature reporting the prevalence of PTSD, ASD and depression following violence related injury treated at the emergency department or hospital. The EMBASE, MEDLINE, Cochrane Central, PubMed, and PsycINFO databases were searched systematically. The quality of the included studies was assessed. RESULTS We included sixteen studies reporting the prevalence rates of PTSD, ASD, or depression. Clear prevalence trajectories could not be identified because the range of prevalence rates was diverse at each time point. Heterogeneity resulting from the use of different diagnostic instruments limited comparability. The included studies were susceptible to bias due to low response rates and loss to follow-up. CONCLUSIONS The differences in diagnostic instruments limited comparability of the prevalence rates. Therefore, clear prevalence trajectories could not be identified. Study participation and loss to follow-up require more attention in future studies. Uniformity in diagnostic procedures is needed in order to draw general conclusions on the prevalence of PTSD, ASD, and depression following violence related injury.
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Affiliation(s)
- Robbin H. Ophuis
- 000000040459992Xgrid.5645.2Department of Public Health, Erasmus University Medical Center, PO Box 2040, 3000 CA Rotterdam, The Netherlands
| | - Branko F. Olij
- 000000040459992Xgrid.5645.2Department of Public Health, Erasmus University Medical Center, PO Box 2040, 3000 CA Rotterdam, The Netherlands
| | - Suzanne Polinder
- 000000040459992Xgrid.5645.2Department of Public Health, Erasmus University Medical Center, PO Box 2040, 3000 CA Rotterdam, The Netherlands
| | - Juanita A. Haagsma
- 000000040459992Xgrid.5645.2Department of Public Health, Erasmus University Medical Center, PO Box 2040, 3000 CA Rotterdam, The Netherlands
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16
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Han C, Park M, Lee JY, Jung HY, Park SM, Choi JS. Dysfunctional information processing in individuals with acute exposure to sexual abuse: An ERP study. Medicine (Baltimore) 2018; 97:e10880. [PMID: 29851807 PMCID: PMC6392618 DOI: 10.1097/md.0000000000010880] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Acute stress disorder (ASD) and posttraumatic stress disorder (PTSD) may occur after traumatic event and also cause significant life time impairment. P300 event-related potential (ERP) is a potential biological marker for PTSD and can reflect cognitive impairment in information processing and attention. Despite the usefulness of ERP, there are few attempts to reveal relationships between ASD and P300. In the present study, we aimed to determine if the P300 of the patients who were the victims of sexual abuse reflected the quantitative trait of ASD or if P300 is applicable as a state marker for predicting the risk of PTSD.Fifteen female victims of sexual abuse diagnosed with ASD and 18 healthy controls (HCs) without trauma exposure participated in this study. We investigated the P300 ERPs in patients with ASD to compare them with those of HCs. ERPs were acquired from female adults during an auditory oddball task. Between-group differences in amplitudes or latencies of P300 were investigated using repeated-measures analysis of variance.The ASD groups showed reduced P300 amplitudes at the midline centroparietal site as well as reduced accuracy rates during an auditory oddball task compared with the HCs.These results indicate that ASD have abnormalities in the P300 compared to those in HCs. Moreover, the reduction in P300 could be considered a candidate neurophysiological marker for ASD.
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Affiliation(s)
- Changwoo Han
- Department of Psychiatry, Eulji University Gangnam Eulji Hospital, Seoul
- Department of Addiction Rehabilitation Social Welfare, Eulji University, Kyunggi
| | - Minkyung Park
- Department of Psychiatry, SMG-SNU Boramae Medical Center
| | - Jun-Young Lee
- Department of Psychiatry, SMG-SNU Boramae Medical Center
- Department of Psychiatry and Behavioral Science
| | - Hee Yeon Jung
- Department of Psychiatry, SMG-SNU Boramae Medical Center
- Department of Psychiatry and Behavioral Science
- Department of Clinical Medical Sciences, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Su Mi Park
- Department of Psychiatry, SMG-SNU Boramae Medical Center
- Department of Clinical Medical Sciences, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Jung-Seok Choi
- Department of Psychiatry, SMG-SNU Boramae Medical Center
- Department of Psychiatry and Behavioral Science
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17
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Nygaard E, Johansen VA, Siqveland J, Hussain A, Heir T. Longitudinal Relationship between Self-efficacy and Posttraumatic Stress Symptoms 8 Years after a Violent Assault: An Autoregressive Cross-Lagged Model. Front Psychol 2017; 8:913. [PMID: 28620334 PMCID: PMC5452477 DOI: 10.3389/fpsyg.2017.00913] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2017] [Accepted: 05/17/2017] [Indexed: 11/25/2022] Open
Abstract
Self-efficacy is assumed to promote posttraumatic adaption, and several cross-sectional studies support this notion. However, there is a lack of prospective longitudinal studies to further illuminate the temporal relationship between self-efficacy and posttraumatic stress symptoms. Thus, an important unresolved research question is whether posttraumatic stress disorder (PTSD) symptoms affect the level of self-efficacy or vice versa or whether they mutually influence each other. The present prospective longitudinal study investigated the reciprocal relationship between general self-efficacy (GSE) and posttraumatic stress symptoms in 143 physical assault victims. We used an autoregressive cross-lagged model across four assessment waves: within 4 months after the assault (T1) and then 3 months (T2), 12 months (T3) and 8 years (T4) after the first assessment. Stress symptoms at T1 and T2 predicted subsequent self-efficacy, while self-efficacy at T1 and T2 was not related to subsequent stress symptoms. These relationships were reversed after T3; higher levels of self-efficacy at T3 predicted lower levels of posttraumatic stress symptoms at T4, while posttraumatic tress symptoms at T3 did not predict self-efficacy at T4. In conclusion, posttraumatic stress symptoms may have a deteriorating effect on self-efficacy in the early phase after physical assault, whereas self-efficacy may promote recovery from posttraumatic stress symptoms over the long term.
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Affiliation(s)
- Egil Nygaard
- Department of Psychology, University of OsloOslo, Norway
| | - Venke A Johansen
- Resource Centre on Violence, Traumatic Stress and Suicide Prevention, Western Norway (RVTS West), Haukeland University HospitalBergen, Norway.,Western Norway University of Applied SciencesBergen, Norway
| | - Johan Siqveland
- Department of Mental Health Services, Akershus University HospitalLørenskog, Norway.,Institute of Clinical Medicine, University of OsloOslo, Norway
| | - Ajmal Hussain
- Department of Mental Health Services, Akershus University HospitalLørenskog, Norway
| | - Trond Heir
- Institute of Clinical Medicine, University of OsloOslo, Norway.,Norwegian Centre for Violence and Traumatic Stress StudiesOslo, Norway
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18
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Hansen NB, Hansen M, Nielsen LH, Elklit A. Positive or negative change in outlook on life following sexual assault and associations to PTSD severity. SEXUAL AND RELATIONSHIP THERAPY 2017. [DOI: 10.1080/14681994.2016.1169266] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Affiliation(s)
- Nina Beck Hansen
- National Research Centre for Psychotraumatology, Department of Psychology, University of Southern Denmark, Odense, Denmark
| | - Maj Hansen
- National Research Centre for Psychotraumatology, Department of Psychology, University of Southern Denmark, Odense, Denmark
| | - Louise Hjort Nielsen
- National Research Centre for Psychotraumatology, Department of Psychology, University of Southern Denmark, Odense, Denmark
| | - Ask Elklit
- National Research Centre for Psychotraumatology, Department of Psychology, University of Southern Denmark, Odense, Denmark
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19
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Kweon YS, Jung NY, Wang SM, Rauch SAM, Chae JH, Lee HK, Lee CT, Lee KU. Psychometric properties of the Korean version of stanford acute stress reaction questionnaire. J Korean Med Sci 2013; 28:1672-6. [PMID: 24265534 PMCID: PMC3835513 DOI: 10.3346/jkms.2013.28.11.1672] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2013] [Accepted: 09/17/2013] [Indexed: 11/20/2022] Open
Abstract
The present study aimed to examine the psychometric properties of the Korean version of Stanford Acute Stress Reaction Questionnaire (SASRQ). A Korean version of the SASRQ was produced through forward translation, reconciliation, and back translation. A total of 100 healthy, non-clinical participants were selected through screening and clinical interview, and they each were given a set of questionnaires including SASRQ. Psychometric properties of SASRQ were then examined through statistical analyses. Full-scale and subscales of SASRQ yielded excellent internal consistency (Cronbach's alpha=0.98 and 0.78-0.95, respectively). Test-retest reliability at 2-week intervals was satisfactory, with coefficient r ranging between 0.47 and 0.71. Convergent validity was also demonstrated by strong correlations between SASRQ and other trauma-related questionnaires. Correlation with Social Desirability Scale, however, was not found to be significant; thus evidenced divergent validity. The Korean version of SASRQ appears to be a reliable and valid measurement tool for assessing symptoms of acute stress disorder. Including clinical samples for comparison with controls would be necessary in future studies.
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Affiliation(s)
- Yong-Sil Kweon
- Department of Psychiatry, Uijeongbu St. Mary's Hospital, The Catholic University of Korea, College of Medicine, Uijeongbu, Korea
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20
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Johansen VA, Eilertsen DE, Nordanger D, Weisaeth L. Prevalence, comorbidity and stability of post-traumatic stress disorder and anxiety and depression symptoms after exposure to physical assault: an 8-year prospective longitudinal study. Nord J Psychiatry 2013; 67:69-80. [PMID: 23130918 DOI: 10.3109/08039488.2012.732112] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND There is a lack of prospective longitudinal studies focusing specifically on the victims exposed to physical violence by a perpetrator other than a family member. AIMS To assess the prevalence and comorbidity of post-traumatic stress disorder (PTSD) and anxiety and depression symptoms and the stability of symptoms, in a population of victims of non-domestic physical violence through 8 years. METHOD This study had a single group longitudinal design with four repeated measures-the first as soon as possible after the exposure (n = 143 at T1), the second 3 months later (n = 94 at T2), the third after 1 year (n = 73 at T3) and the fourth after 8 years (n = 47 at T4). Questionnaires used were Impact of Event Scale-15 and 22 (IES-15 and 22), Post Traumatic Symptom Scale-10 (PTSS-10) and the Hopkins Symptoms Check List (HSCL-25). RESULTS Probable PTSD cases measured with IES-15 were 33.6% at T1, 30.9 at T2, 30.1% at T3 (12 months) and 19.1% at T4 (8 years), while probable anxiety and depression cases measured with HSCL-25 were 42.3% at T1, 35.5% at T2, 35.6% at T3 and 23.4% at T4. The estimated probability of recovery from PTSD symptoms during the 8 years is 52%, whereas the corresponding finding concerning anxiety and depression is 43%. CONCLUSION The consequences of exposure to physical assault by strangers need to be given more attention as a severe risk of chronic mental health problems.
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Affiliation(s)
- Venke A Johansen
- Resource Centre on Violence, Traumatic Stress and Suicide Prevention, Western Norway (RVTS West), Haukeland University Hospital, Bergen, Norway.
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21
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Hansen M, Elklit A. Does acute stress disorder predict posttraumatic stress disorder following bank robbery? JOURNAL OF INTERPERSONAL VIOLENCE 2013; 28:25-44. [PMID: 22829214 DOI: 10.1177/0886260512448848] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Unfortunately, the number of bank robberies is increasing and little is known about the subsequent risk of posttraumatic stress disorder (PTSD). Several studies have investigated the prediction of PTSD through the presence of acute stress disorder (ASD). However, there have only been a few studies following nonsexual assault. The present study investigated the predictive power of different aspects of the ASD diagnosis and symptom severity on PTSD prevalence and symptom severity in 132 bank employees. The PTSD diagnosis, based on the three core symptom clusters, was best identified using cutoff scores on the Acute Stress Disorder scale. ASD severity accounted for 40% and the inclusion of other risk factors accounted for 50% of the PTSD severity variance. In conclusion, results indicated that ASD appears to predict PTSD differently following nonsexual assault than other trauma types. ASD severity was a stronger predictor of PTSD than ASD diagnosis.
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Affiliation(s)
- Maj Hansen
- National Centre for Psychotraumatology, University of Southern Denmark, Campusvej 55, 5230 Odense M, Denmark.
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22
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Armour C, Shevlin M, Elklit A, Mroczek D. A Latent Growth Mixture Modeling Approach to PTSD Symptoms in Rape Victims. TRAUMATOLOGY 2012; 18:20-28. [PMID: 22661909 PMCID: PMC3365569 DOI: 10.1177/1534765610395627] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The research literature has suggested that longitudinal changes in posttraumatic stress disorder (PTSD) could be adequately described in terms of one universal trajectory, with individual differences in baseline levels (intercept) and rate of change (slope) being negligible. However, not everyone who has experienced a trauma is diagnosed with PTSD, and symptom severity levels differ between individuals exposed to similar traumas. The current study employed the latent growth mixture modeling technique to test for multiple trajectories using data from a sample of Danish rape victims (N = 255). In addition, the analysis aimed to determine whether a number of explanatory variables could differentiate between the trajectories (age, acute stress disorder [ASD], and perceived social support). Results concluded the existence of two PTSD trajectories. ASD was found to be the only significant predictor of one trajectory characterized by high initial levels of PTSD symptomatology. The present findings confirmed the existence of multiple trajectories with regard to PTSD symptomatology in a way that may be useful to clinicians working with this population.
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Affiliation(s)
- Cherie Armour
- University of Ulster, Magee Campus, Londonderry, Northern Ireland, UK
- The National Centre for Psychotraumatology, University of Southern Denmark, Odense, Denmark
| | - Mark Shevlin
- University of Ulster, Magee Campus, Londonderry, Northern Ireland, UK
| | - Ask Elklit
- The National Centre for Psychotraumatology, University of Southern Denmark, Odense, Denmark
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23
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Bryant RA, Creamer M, O'Donnell M, Silove D, McFarlane AC. The capacity of acute stress disorder to predict posttraumatic psychiatric disorders. J Psychiatr Res 2012; 46:168-73. [PMID: 22088925 DOI: 10.1016/j.jpsychires.2011.10.007] [Citation(s) in RCA: 59] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2010] [Revised: 09/19/2011] [Accepted: 10/18/2011] [Indexed: 11/18/2022]
Abstract
BACKGROUND One rationale for establishing the acute stress disorder diagnosis was to identify recently trauma-exposed people who may develop later posttraumatic stress disorder (PTSD). This study conducted a multi-site assessment of the extent to which ASD predicts subsequent PTSD, and also major depressive disorder, panic disorder, agoraphobia, social phobia, specific phobia, generalized anxiety disorder, and substance use disorder, 12 months after trauma. METHOD Consecutive admissions to 5 major trauma hospitals across Australia (N = 1084) were assessed during hospital admission and within one month of trauma exposure and subsequently re-assessed for psychiatric disorder 12 months after the initial assessment (N = 859). RESULTS Whereas 120 (10%) patients met criteria for ASD in the initial month after trauma, 83 (10%) met criteria for PTSD, and 268 (31%) had any psychiatric disorder at 12 months. In terms of those diagnosed with ASD, 28 (36%) subsequently met criteria for PTSD and 50 (65%) subsequently developed any psychiatric disorder. CONCLUSIONS Whereas the majority of people with ASD subsequently develop a psychiatric disorder, most people with a disorder at 12 months do not initially display ASD.
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Bryant RA, Friedman MJ, Spiegel D, Ursano R, Strain J. A review of acute stress disorder in DSM-5. Depress Anxiety 2011; 28:802-17. [PMID: 21910186 DOI: 10.1002/da.20737] [Citation(s) in RCA: 91] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2010] [Revised: 06/24/2010] [Accepted: 06/24/2010] [Indexed: 11/07/2022] Open
Abstract
Acute stress disorder (ASD) was introduced into DSM-IV to describe acute stress reactions (ASRs) that occur in the initial month after exposure to a traumatic event and before the possibility of diagnosing posttraumatic stress disorder (PTSD), and to identify trauma survivors in the acute phase who are high risk for PTSD. This review considers ASD in relation to other diagnostic approaches to acute stress responses, critiques the evidence of the predictive power of ASD, and discusses ASD in relation to Adjustment Disorder. The evidence suggests that ASD does not adequately identify most people who develop PTSD. This review presents a number of options and preliminary considerations to be considered for DSM-5. It is proposed that ASD be limited to describing severe ASRs (that are not necessarily precursors of PTSD). The evidence suggests that the current emphasis on dissociation may be overly restrictive and does not recognize the heterogeneity of early posttraumatic stress responses. It is proposed that ASD may be better conceptualized as the severity of acute stress responses that does not require specific clusters to be present.
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Affiliation(s)
- Richard A Bryant
- School of Psychology, University of New South Wales, New South Wales, Australia.
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25
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Hansen M, Elklit A. Predictors of acute stress disorder in response to bank robbery. Eur J Psychotraumatol 2011; 2:EJPT-2-5864. [PMID: 22893821 PMCID: PMC3402148 DOI: 10.3402/ejpt.v2i0.5864] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2010] [Revised: 04/17/2011] [Accepted: 04/19/2011] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Research has shown that robberies in the workplace, in particular those in the bank sector are traumatising events for many employees. However, research in the acute sequelae of bank robberies is limited. OBJECTIVE AND DESIGN The present study explores the prevalence and predictors of acute stress disorder (ASD) in a questionnaire survey of bank employees following a bank robbery. RESULTS Results show that 14.5% (n=22) of participants (N=152) suffered from probable ASD, which is similar to the ASD prevalence found in other interpersonal assault studies. In addition, a number of associations were found between ASD severity, gender, age, social support, previous trauma, and trauma severity. In the final hierarchical multiple regression model, which included 12 variables, 66% of the variance in ASD symptom level was accounted for by two peri-trauma variables (perceived helplessness and perceived life threat) and one post-trauma variable (perceived safety after the robbery). CONCLUSIONS The present study yielded some promising results with regards to the influential role of peri-traumatic and post-traumatic variables in predicting ASD after a bank robbery-in particular perceived safety. Although there may be different paths to developing ASD and PTSD, a common core feature may be perceived safety. Furthermore, the results also supported the inclusion of perceived helplessness in the A2 criterion of the DSM-IV ASD diagnosis.
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Affiliation(s)
- Maj Hansen
- National Centre for Psychotraumatology, University of Southern Denmark, Odense, Denmark
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Abstract
In recent years, a number of studies have investigated the prediction of posttraumatic stress disorder (PTSD) through the presence of acute stress disorder (ASD). The predictive power of ASD on PTSD was examined in a population of 148 female rape victims who visited a center for rape victims shortly after the rape or attempted rape. The PTSD diagnosis based solely on the three core symptom clusters was best identified by a subclinical ASD diagnosis based on all ASD criteria except dissociation. However, a full PTSD diagnosis including the A( 2) and F criteria was best identified by classifying victims according to a full ASD diagnosis. Regardless of whether cases were classified according to full PTSD status or according to meeting the criteria for the three PTSD core symptom clusters, the classification was correct only in approximately two thirds of the cases. A regression analysis based on ASD severity and sexual problems following the rape accounted for only 28% of the PTSD severity variance. In conclusion, the ASD diagnosis is not an optimal method for identifying those most at risk for PTSD. It remains to be seen whether a better way can be found.
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MESH Headings
- Adaptation, Psychological
- Adolescent
- Adult
- Aged
- Aged, 80 and over
- Child
- Crime/psychology
- Denmark/epidemiology
- Female
- Humans
- Middle Aged
- Prevalence
- Psychiatric Status Rating Scales
- Psychometrics/statistics & numerical data
- Rape/psychology
- Regression Analysis
- Risk Factors
- Severity of Illness Index
- Stress Disorders, Post-Traumatic/diagnosis
- Stress Disorders, Post-Traumatic/epidemiology
- Stress Disorders, Post-Traumatic/psychology
- Stress Disorders, Traumatic, Acute/diagnosis
- Stress Disorders, Traumatic, Acute/epidemiology
- Stress Disorders, Traumatic, Acute/psychology
- Young Adult
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Abstract
INTRODUCTION The aim of this study was to find characteristics in head-neck-facial (HNF) injuries among victims of violence and to test the hypothesis that the type of injury, location, and mechanism behind it vary between the genders. METHODS A 1-year prospective study including all victims of violence attending the Accident & Emergency (A&E) Department or the Institute of Forensic Medicine in Aarhus was conducted. Every violence-related injury was recorded along with the mechanism behind it, the type of injury, and the specific anatomic location. RESULTS A total of 1,106 victims were examined of whom 83% had HNF injuries. Thirty-seven percent had more than one HNF injury. Injuries around the nose and mouth were significantly associated with male victims, whereas injuries to the neck were significantly more common among female victims. Most injuries were the results of assault with a blunt object, where the men much more frequently had open wounds, whereas injuries such as ecchymoses were significantly more frequent among female victims. Use of weapons, such as blunt objects and blows with glass/bottles, was associated much more with male victims, whereas strangulation attempts were significantly more frequent among women. Ten percent of the women had been exposed to strangulation attempts. DISCUSSION The findings support former studies that HNF injuries might be considered as markers of violence. Thus, the staff at A&E Departments must consider anyone with these types of injuries as potential victims of violence. The A&E Department may be the primary entrance for the victims and the main way in which to offer help. The high incidence of women who had been assaulted with strangulation, which is a potentially very dangerous trauma mechanism, intensifies the importance of conducting a careful medical examination, in part, because of the possible legal implications. CONCLUSION HNF injuries are characteristic among victims of violence, although significant differences exist in the type of injuries, the location, and the trauma mechanism between men and women.
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Affiliation(s)
- Ole Brink
- Trauma Research Unit, Department of Orthopaedics, Aarhus University Hospital, Aarhus C, Denmark.
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Cognitive vulnerabilities to the development of PTSD: A review of four vulnerabilities and the proposal of an integrative vulnerability model. Clin Psychol Rev 2009; 29:87-100. [DOI: 10.1016/j.cpr.2008.10.002] [Citation(s) in RCA: 178] [Impact Index Per Article: 11.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2007] [Revised: 10/07/2008] [Accepted: 10/13/2008] [Indexed: 11/22/2022]
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Shakibaei F, Harandi AA, Gholamrezaei A, Samoei R, Salehi P. Hypnotherapy in management of pain and reexperiencing of trauma in burn patients. Int J Clin Exp Hypn 2008; 56:185-97. [PMID: 18307128 DOI: 10.1080/00207140701849536] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
This study examined the effects of hypnosis on both pain and reexperiencing of trauma in burn patients. Forty-four patients hospitalized for burn care were randomly assigned to either hypnotherapy or a control group. Direct and indirect hypnotic suggestions were used to reduce pain and reexperiencing of trauma. All patients received routine burn care. Pain reports were quantified by using a self-report numeric rating scale ranging from 0 to 5. The number of recalled vivid, troubling events of the trauma in 24-hour intervals was used for rating the reexperiencing of trauma. The hypnotherapy group showed significantly lower pain ratings than the control group and reported a significant reduction in pain from baseline. There was a significant reduction in trauma reexperience scores in the hypnotherapy group but not the control group. The findings support the efficacy of hypnotherapy in the management of both pain and reexperiencing of trauma in burn patients.
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Abstract
BACKGROUND Some studies suggest that early psychological treatment is effective in preventing chronic post-traumatic stress disorder (PTSD), but it is as yet unclear how best to identify trauma survivors who need such intervention. This prospective longitudinal study investigated the prognostic validity of acute stress disorder (ASD), of variables derived from a meta-analysis of risk factors for PTSD, and of candidate cognitive and biological variables in predicting chronic PTSD following assault. METHOD Assault survivors who had been treated for their injuries at a metropolitan Accident and Emergency (A&E) Department were assessed with structured clinical interviews to establish diagnoses of ASD at 2 weeks (n=222) and PTSD at 6 months (n=205) after the assault. Candidate predictors were assessed at 2 weeks. RESULTS Most predictors significantly predicted PTSD status at follow-up. Multivariate logistic regressions showed that a set of four theory-derived cognitive variables predicted PTSD best (Nagelkerke R2=0.50), followed by the variables from the meta-analysis (Nagelkerke R2=0.37) and ASD (Nagelkerke R2=0.25). When all predictors were considered simultaneously, mental defeat, rumination and prior problems with anxiety or depression were chosen as the best combination of predictors (Nagelkerke R2=0.47). CONCLUSION Questionnaires measuring mental defeat, rumination and pre-trauma psychological problems may help to identify assault survivors at risk of chronic PTSD.
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Affiliation(s)
- BIRGIT KLEIM
- Institute of Psychiatry, Department of Psychology,
King's College London, London, UK
| | - ANKE EHLERS
- Institute of Psychiatry, Department of Psychology,
King's College London, London, UK
| | - EDWARD GLUCKSMAN
- Accident and Emergency Department, King's College
Hospital London, London, UK
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Temple JR, Weston R, Rodriguez BF, Marshall LL. Differing effects of partner and nonpartner sexual assault on women's mental health. Violence Against Women 2007; 13:285-97. [PMID: 17322272 DOI: 10.1177/1077801206297437] [Citation(s) in RCA: 59] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
This study contrasted the effects of intimate partner and nonpartner sexual assault on women's mental health among a sample (N=835) of low-income, ethnically diverse community women. Compared to sexual assault by a previous partner or by a non-intimate partner, sexual assault by a current partner was the strongest predictor of PTSD, stress, and dissociation. Non-intimate partner sexual assault was only a significant predictor of PTSD and only for African American women. These findings suggest that the victim-offender relationship is important when considering the impact of sexual assault. Specifically, sexual assault perpetrated by an intimate partner may be especially traumatic.
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Johansen VA, Wahl AK, Eilertsen DE, Weisaeth L. Prevalence and predictors of post-traumatic stress disorder (PTSD) in physically injured victims of non-domestic violence. A longitudinal study. Soc Psychiatry Psychiatr Epidemiol 2007; 42:583-93. [PMID: 17530151 DOI: 10.1007/s00127-007-0205-0] [Citation(s) in RCA: 62] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/04/2007] [Indexed: 11/26/2022]
Abstract
BACKGROUND Victims of violent assault experience diverse post-event emotional problems such as post-traumatic stress disorder (PTSD), and they may have multiple emotional problems. The aim of the present study was to evaluate the prevalence and predictors of PTSD in a longitudinal design. METHODS The levels of physical injury, perceived life threat, prior experience of violence, peritraumatic dissociation (PD), acute PTSD, perceived self-efficacy and perceived social support are considered possible predictors. This study had a single group (N = 70), longitudinal design with three repeated measures over a period of 12 months. Questionnaires used were: Impact of Event Scale-15 and 22 (IES-15 and 22), Post-Traumatic Symptom Scale-10 (PTSS-10), Peritraumatic Dissociation (PD) 7-item self-report measure, Social Provisions Scale (SPS) and Generalized Self-Efficacy scale (GSE). RESULTS Results showed a high prevalence and severity of PTSD on all outcomes, for instance 31% scored as probable PTSD-cases and 14% as risk level cases by IES-15 at T3. Either injury severity or prior experience of being a victim of violence predicted PTSD in this study. Early PTSD predicted subsequent PTSD, and perceived life threat was a predictor of PD. Furthermore, lack of perceived social support was a predictor of PTSD symptoms at T3. In addition, low perceived self-efficacy was a predictor of PTSD and influenced perceived social support at T1. CONCLUSIONS Our results showed that experience of non-domestic violence may cause serious chronic emotional problems, and therefore it is important to be aware of early symptoms indicating needs for special follow-ups.
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Affiliation(s)
- Venke A Johansen
- Faculty of Health, Buskerud University College, Buskerud, Norway.
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Johansen VA, Wahl AK, Eilertsen DE, Weisaeth L, Hanestad BR. The predictive value of post-traumatic stress disorder symptoms for quality of life: a longitudinal study of physically injured victims of non-domestic violence. Health Qual Life Outcomes 2007; 5:26. [PMID: 17517126 PMCID: PMC1892772 DOI: 10.1186/1477-7525-5-26] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2007] [Accepted: 05/21/2007] [Indexed: 11/23/2022] Open
Abstract
Background Little is known about longitudinal associations between post-traumatic stress disorder (PTSD) and quality of life (QoL) after exposure to violence. The aims of the current study were to examine quality of life (QoL) and the predictive value of post-traumatic stress disorder (PTSD) for QoL in victims of non-domestic violence over a period of 12 months. Methods A single-group (n = 70) longitudinal design with three repeated measures over a period of 12 months were used. Posttraumatic psychological symptoms were assessed by using the Impact of Event Scale, a 15-item self-rating questionnaire comprising two subscales (intrusion and avoidance) as a screening instrument for PTSD. The questionnaire WHOQOL-Bref was used to assess QoL. The WHOQOL-BREF instrument comprises 26 items, which measure the following broad domains: physical health, psychological health, social relationships, and environment. Results of the analysis were summarized by fitting Structural Equation Modelling (SEM). Results For each category of PTSD (probable cases, risk level cases and no cases), the mean levels of the WHOQOL-Bref subscales (the four domains and the two single items) were stable across time of assessment. Individuals who scored as probable PTSD or as risk level cases had significantly lower scores on the QoL domains such as physical health, psychological health, social relationships and environmental than those without PTSD symptoms. In addition, the two items examining perception of overall quality of life and perception of overall health in WHOQOL showed the same results according to PTSD symptoms such as QoL domains. PTSD symptoms predicted lower QoL at all three assessments. Similarly PTSD symptoms at T1 predicted lower QoL at T2 and PTSD symptoms at T2 predicted lower QoL at T3. Conclusion The presence of PTSD symptoms predicted lower QoL, both from an acute and prolonged perspective, in victims of non-domestic violence. Focusing on the individual's perception of his/her QoL in addition to the illness may increase the treatment priorities and efforts.
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Affiliation(s)
- Venke A Johansen
- Faculty of Health Buskerud University College, Konggt 51, 3019 Drammen, Norway
- Resource Centre on Violence, Traumatic Stress and Suicide Prevention, Western Norway (RVTS-West), Ulriksdalen 2, Helse Bergen, Haukeland University Hospital, Norway
| | - Astrid K Wahl
- Institute of Nursing and Health Sciences Medical Faculty, University of Oslo, Pb 1153 Blindern, 0316 Oslo, Norway
| | - Dag Erik Eilertsen
- Department of Psychology, University of Oslo, Pb 1094 Blindern, 0317 Oslo, Norway
| | - Lars Weisaeth
- Norwegian Centre for Violence and Traumatic Stress Studies (NKVTS), Ullevål University Hospital, Kirkeveien 116, 0407 Oslo, Norway
| | - Berit R Hanestad
- Department of Public Health and Primary Health Care, University of Bergen, Kalfarveien 31, 5018 Bergen, Norway
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Kutz I, Dekel R. Follow-up of victims of one terrorist attack in Israel: ASD, PTSD and the perceived threat of Iraqi missile attacks. PERSONALITY AND INDIVIDUAL DIFFERENCES 2006. [DOI: 10.1016/j.paid.2006.01.002] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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