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Liu VC, Nelson LE, Shorey S. Experiences of Women Receiving Trauma-Informed Care: A Qualitative Systematic Review. TRAUMA, VIOLENCE & ABUSE 2024:15248380241234346. [PMID: 38804687 DOI: 10.1177/15248380241234346] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/29/2024]
Abstract
Exposure to trauma elevates the risk of illness in women, resulting in increased healthcare costs. The trauma-informed care approach seeks to enhance patient engagement and promote more effective recovery for those with a history of psychological trauma. This qualitative systematic review aims to synthesize evidence related to the experiences of women receiving trauma-informed care using Sandelowski and Barroso's two-step approach for qualitative research synthesis. A comprehensive search was conducted across 10 electronic databases from their inception until September 2023, coupled with an extensive bibliography search of relevant studies and reviews. In total, eleven studies meeting the inclusion criteria were selected: qualitative peer-reviewed and non-peer-reviewed studies in English with findings on the experiences of adult heterosexual women aged 19 to 64 years old who underwent various trauma-informed psychosocial interventions. From these studies, four main themes emerged, elucidating women's experiences as they engage with trauma-informed care: (a) Readiness to seek healing; (b) Healthcare providers: Extending the first hand; (c) An empowering paradigm shift; and (d) Better days ahead. Our major findings emphasize the importance of healthcare providers demonstrating sensitivity to trauma and culture, adopting a gender-sensitive approach, and taking a proactive stance in initiating discussions about trauma. Moreover, allocating more time for consultations, with an increased focus on building an initial rapport to ensure women's comfort, is also vital. The review further underscores the benefits of group sessions in aiding women's recovery from trauma. Ultimately, this review holds substantial implications for shaping future practices, emphasizing the critical necessity of personalized treatment plans.
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Thursby S, Dismore L, Swainston K. Clinical skills development for healthcare practitioners working with patients with persistent physical symptoms (PPS) in healthcare settings: a systematic review and narrative synthesis. BMC MEDICAL EDUCATION 2024; 24:328. [PMID: 38519955 PMCID: PMC10960475 DOI: 10.1186/s12909-024-05306-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Accepted: 03/13/2024] [Indexed: 03/25/2024]
Abstract
BACKGROUND The complexity and uncertainty around Persistent Physical Symptoms (PPS) make it difficult to diagnose and treat, particularly under time-constrained consultations and limited knowledge. Brief interventions that can be utilised in day-to-day practice are necessary to improve ways of managing PPS. This review aimed to establish (i) what training primary and secondary healthcare practitioners have undertaken to develop their clinical skills when working with PPS, (ii) what training techniques or theoretical models have been used within these interventions, and (iii) how effective was the training. METHOD A systematic literature search was undertaken on eight databases to identify professional development interventions for healthcare practitioners working with PPS, were of any study design, and at a minimum were single measure studies (i.e., training outcome alone). Studies were assessed using the Mixed Methods Appraisal Tool (MMAT) and narratively synthesised. RESULTS Despite high methodological heterogeneity across the six included studies, they all aimed to improve healthcare practitioners' communication skills through educational (theory, awareness, attitudes, assessment, treatment, and management of PPS) and experiential (role play) learning. CONCLUSIONS The review findings demonstrate that developing healthcare practitioners' communicative behaviours led to increased confidence and self-efficacy when working with PPS, which facilitated improved consultations and improvements on some patient outcomes. Barriers to the uptake of training programmes and implementation into daily clinical practice are discussed, including the need for PPS to be formally implemented into undergraduate teaching and post-qualification continuous professional development. TRIAL REGISTRATION This review was registered at PROSPERO [CRD42022315631] prior to the review starting.
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Affiliation(s)
- Stacie Thursby
- Northumbria Healthcare NHS Foundation Trust, North Tyneside General Hospital, North Shields, NE29 8NH, United Kingdom
| | - Lorelle Dismore
- Northumbria Healthcare NHS Foundation Trust, North Tyneside General Hospital, North Shields, NE29 8NH, United Kingdom
| | - Katherine Swainston
- Faculty of Medical Sciences, School of Psychology, Newcastle University, 4 Floor Dame Margaret Barbour Building, Wallace Street, Newcastle Upon Tyne, NE1 7RU, England.
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Liu J, Roberts AL, Lawn RB, Jha SC, Sampson L, Sumner JA, Kang JH, Rimm EB, Grodstein F, Liang L, Haneuse S, Kubzansky LD, Koenen KC, Chibnik LB. Post-traumatic stress disorder symptom remission and cognition in a large cohort of civilian women. Psychol Med 2024; 54:419-430. [PMID: 37577959 PMCID: PMC10947504 DOI: 10.1017/s0033291723001915] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/15/2023]
Abstract
BACKGROUND Post-traumatic stress disorder (PTSD) is associated with cognitive impairments. It is unclear whether problems persist after PTSD symptoms remit. METHODS Data came from 12 270 trauma-exposed women in the Nurses' Health Study II. Trauma and PTSD symptoms were assessed using validated scales to determine PTSD status as of 2008 (trauma/no PTSD, remitted PTSD, unresolved PTSD) and symptom severity (lifetime and past-month). Starting in 2014, cognitive function was assessed using the Cogstate Brief Battery every 6 or 12 months for up to 24 months. PTSD associations with baseline cognition and longitudinal cognitive changes were estimated by covariate-adjusted linear regression and linear mixed-effects models, respectively. RESULTS Compared to women with trauma/no PTSD, women with remitted PTSD symptoms had a similar cognitive function at baseline, while women with unresolved PTSD symptoms had worse psychomotor speed/attention and learning/working memory. In women with unresolved PTSD symptoms, past-month PTSD symptom severity was inversely associated with baseline cognition. Over follow-up, both women with remitted and unresolved PTSD symptoms in 2008, especially those with high levels of symptoms, had a faster decline in learning/working memory than women with trauma/no PTSD. In women with remitted PTSD symptoms, higher lifetime PTSD symptom severity was associated with a faster decline in learning/working memory. Results were robust to the adjustment for sociodemographic, biobehavioral, and health factors and were partially attenuated when adjusted for depression. CONCLUSION Unresolved but not remitted PTSD was associated with worse cognitive function assessed six years later. Accelerated cognitive decline was observed among women with either unresolved or remitted PTSD symptoms.
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Affiliation(s)
- Jiaxuan Liu
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Andrea L. Roberts
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Rebecca B. Lawn
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Shaili C. Jha
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Laura Sampson
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Jennifer A. Sumner
- Department of Psychology, University of California, Los Angeles, CA, Los Angeles, CA, USA
| | - Jae H. Kang
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, USA
| | - Eric B. Rimm
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, USA
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Francine Grodstein
- Rush Alzheimer’s Disease Center, Rush University Medical Center, Chicago, IL, USA
| | - Liming Liang
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Sebastien Haneuse
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Laura D Kubzansky
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Karestan C. Koenen
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Psychiatric and Neurodevelopmental Genetics Unit, Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
| | - Lori B. Chibnik
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Department of Neurology, Massachusetts General Hospital, Boston MA, USA
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Nass BYS, Dibbets P, Markus CR. The Impact of Psychotrauma and Emotional Stress Vulnerability on Physical and Mental Functioning of Patients with Inflammatory Bowel Disease. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6976. [PMID: 37947534 PMCID: PMC10648781 DOI: 10.3390/ijerph20216976] [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: 01/13/2023] [Revised: 10/06/2023] [Accepted: 10/22/2023] [Indexed: 11/12/2023]
Abstract
Inflammatory bowel disease (IBD) is a chronic health condition thought to be influenced by personal life experiences and emotional stress sensitivity (neuroticism). In the present study, we examined the impact of cumulative trauma experiences and trait neuroticism (as a measure for emotional stress vulnerability) on physical and mental functioning of n = 211 patients diagnosed with IBD (112 Crohn's disease, 99 ulcerative colitis). All patients were assessed for self-reported trauma histories, emotional stress vulnerability, clinical disease activity, functional gastrointestinal (GI) symptoms, and quality of life. Results showed that patients with severe IBD activity have endured significantly more interpersonal trauma and victimization than those with quiescent IBD. Moreover, cumulative trauma was found to exert an indirect (neuroticism-mediated) effect on patients' symptom complexity, with trauma and neuroticism conjointly explaining 16-21% of the variance in gastrointestinal and 35% of the variance in mental symptoms. Upon correction for condition (using a small group of available controls, n = 51), the predictive capacity of trauma and neuroticism increased further, with both predictors now explaining 31% of the somatic-and almost 50% of the mental symptom heterogeneity. In terms of trauma type, victimization (domestic violence and intimate abuse) proved the best predictor of cross-sample symptom variability and the only trauma profile with a consistent direct and indirect (neuroticism-mediated) effect on patients' mental (QoL) and physical fitness. Results are consistent with the growing body of evidence linking experiential vulnerability factors (trauma and neuroticism) and associated feelings of personal ineffectiveness, helplessness, and uncontrollability to interindividual differences in (GI) disease activity and quality of life.
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Affiliation(s)
- Boukje Yentl Sundari Nass
- Department of Neuropsychology and Psychopharmacology, Faculty of Psychology and Neuroscience, Maastricht University, P.O. Box 616, 6200 MD Maastricht, The Netherlands
- Dr. Rath Health Foundation, 6422 RG Heerlen, The Netherlands
| | - Pauline Dibbets
- Clinical Psychological Science, Maastricht University, P.O. Box 616, 6200 MD Maastricht, The Netherlands
| | - C. Rob Markus
- Department of Neuropsychology and Psychopharmacology, Faculty of Psychology and Neuroscience, Maastricht University, P.O. Box 616, 6200 MD Maastricht, The Netherlands
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Sumner JA, Cleveland S, Chen T, Gradus JL. Psychological and biological mechanisms linking trauma with cardiovascular disease risk. Transl Psychiatry 2023; 13:25. [PMID: 36707505 PMCID: PMC9883529 DOI: 10.1038/s41398-023-02330-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2022] [Revised: 01/18/2023] [Accepted: 01/20/2023] [Indexed: 01/28/2023] Open
Abstract
Cardiovascular disease (CVD) is the leading cause of death and disability worldwide, and experiences of psychological trauma have been associated with subsequent CVD onset. Identifying key pathways connecting trauma with CVD has the potential to inform more targeted screening and intervention efforts to offset elevated cardiovascular risk. In this narrative review, we summarize the evidence for key psychological and biological mechanisms linking experiences of trauma with CVD risk. Additionally, we describe various methodologies for measuring these mechanisms in an effort to inform future research related to potential pathways. With regard to mechanisms involving posttraumatic psychopathology, the vast majority of research on psychological distress after trauma and CVD has focused on posttraumatic stress disorder (PTSD), even though posttraumatic psychopathology can manifest in other ways as well. Substantial evidence suggests that PTSD predicts the onset of a range of cardiovascular outcomes in trauma-exposed men and women, yet more research is needed to better understand posttraumatic psychopathology more comprehensively and how it may relate to CVD. Further, dysregulation of numerous biological systems may occur after trauma and in the presence of posttraumatic psychopathology; these processes of immune system dysregulation and elevated inflammation, oxidative stress, mitochondrial dysfunction, renin-angiotensin system dysregulation, and accelerated biological aging may all contribute to subsequent cardiovascular risk, although more research on these pathways in the context of traumatic stress is needed. Given that many of these mechanisms are closely intertwined, future research using a systems biology approach may prove fruitful for elucidating how processes unfold to contribute to CVD after trauma.
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Affiliation(s)
- Jennifer A Sumner
- Department of Psychology, University of California, Los Angeles, Los Angeles, CA, USA.
| | - Shiloh Cleveland
- Department of Psychology, University of California, Los Angeles, Los Angeles, CA, USA
| | - Tiffany Chen
- Department of Psychology, University of California, Los Angeles, Los Angeles, CA, USA
| | - Jaimie L Gradus
- Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA
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Cusack SE, Bountress KE, Lind MJ, Hawn SE, Dick DM, Amstadter AB. Trauma exposure, alcohol consumption, and sleep quality: a latent growth curve model. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2022; 70:2126-2134. [PMID: 33258742 PMCID: PMC8166935 DOI: 10.1080/07448481.2020.1845181] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/15/2020] [Revised: 10/20/2020] [Accepted: 10/25/2020] [Indexed: 06/12/2023]
Abstract
This study examined the relations among precollege trauma exposure, alcohol use upon entering college, growth in alcohol use, and sleep quality in a sample of undergraduate students. Participants were 932 students from a large, urban, public university. Participants completed a survey upon entering college and then subsequent follow-up surveys each Spring semester. Precollege trauma exposure was associated with both baseline and growth in alcohol use, whereby higher levels of trauma were associated with higher baseline alcohol use, but with less steep increases in growth rate, as compared to those with lower levels of trauma. Baseline alcohol use was associated with sleep quality whereby those with higher levels of consumption demonstrated worsened sleep quality. This study provides longitudinal evidence for the relations among trauma, alcohol use, and sleep quality. Although the relationship between trauma and alcohol is well-established, further work is needed to identify how this relationship impacts additional health outcomes.
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Affiliation(s)
- S E Cusack
- Virginia Institute for Psychiatric and Behavioral Genetics, Richmond, Virginia, USA
- Department of Psychology, Virginia Commonwealth University, Richmond, Virginia, USA
| | - K E Bountress
- Virginia Institute for Psychiatric and Behavioral Genetics, Richmond, Virginia, USA
| | - M J Lind
- Virginia Institute for Psychiatric and Behavioral Genetics, Richmond, Virginia, USA
| | - S E Hawn
- Virginia Institute for Psychiatric and Behavioral Genetics, Richmond, Virginia, USA
- Department of Psychology, Virginia Commonwealth University, Richmond, Virginia, USA
| | - D M Dick
- Department of Psychology, Virginia Commonwealth University, Richmond, Virginia, USA
- Department of Human and Molecular Genetics, Virginia Commonwealth University, Richmond, Virginia, USA
| | - A B Amstadter
- Virginia Institute for Psychiatric and Behavioral Genetics, Richmond, Virginia, USA
- Department of Psychology, Virginia Commonwealth University, Richmond, Virginia, USA
- Department of Human and Molecular Genetics, Virginia Commonwealth University, Richmond, Virginia, USA
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Noushad S, Ansari B, Ahmed S. Effect of nature-based physical activity on post-traumatic growth among healthcare providers with post-traumatic stress. Stress Health 2022; 38:813-826. [PMID: 35191173 DOI: 10.1002/smi.3135] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Revised: 02/09/2022] [Accepted: 02/14/2022] [Indexed: 11/11/2022]
Abstract
The purpose of this randomized control trial was to observe the effect of nature-based physical activity in achieving post traumatic growth and to estimate the combined effect of nature and physical activity on the psychophysiological outcomes. A 3-month therapy was provided to participants meeting eligibility criteria to receive the walk-in nature (experimental group) or sit-in nature (control group) in the 1:1 ratio. At baseline and 3-month follow-up, participants were assessed with Trauma Symptom Checklist 40, Traumatic Stress Scale, Post-Traumatic Growth Inventory (PTGI), Cortisol, C-Reactive Protein (CRP), Interleukin-6 (IL-6), Brain-Derived Neurotropic Factor (BDNF) and heart rate variability. There was a significant effect of nature-based physical activity on traumatic stress and post-traumatic growth in comparison with the sit-in control. A significant post-interventional difference was observed in the mean PTGI score [F = 5.412, p = 0.022] between the experimental and control groups after 3 months of intervention. All the biochemical estimates, including CRP, BDNF, IL-6, and cortisol levels, were significantly altered in both post-intervention study groups (p < 0.01). Taken together, these results show that nature-based physical activity significantly improves psychophysiological outcomes induced as a result of post-traumatic growth and also reduces traumatic stress.
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Affiliation(s)
- Shamoon Noushad
- Department of Health, Physical Education and Sports Sciences, University of Karachi, Karachi, Pakistan.,Department of Physiology, Psychophysiology Research Lab, University of Karachi, Karachi, Pakistan
| | - Basit Ansari
- Department of Health, Physical Education and Sports Sciences, University of Karachi, Karachi, Pakistan
| | - Sadaf Ahmed
- Department of Physiology, Psychophysiology Research Lab, University of Karachi, Karachi, Pakistan
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Fu Q. Autonomic dysfunction and cardiovascular risk in post-traumatic stress disorder. Auton Neurosci 2021; 237:102923. [PMID: 34844132 DOI: 10.1016/j.autneu.2021.102923] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2020] [Revised: 09/28/2021] [Accepted: 11/13/2021] [Indexed: 01/15/2023]
Abstract
BACKGROUND Patients with post-traumatic stress disorder (PTSD) have an increased risk for cardiovascular disease. The underlying mechanisms are unclear but impaired autonomic function may contribute. However, research in this field has shown contradictory results and the causal links between PTSD, autonomic dysfunction, and cardiovascular risk remain unknown. This brief review summarizes the current knowledge on alterations in autonomic function and cardiovascular risk in patients with PTSD. LITERATURE SEARCH STRATEGY A PubMed search of the literature was performed using the following keywords: autonomic function, heart rate variability, blood pressure variability, sympathetic activity, baroreflex function, and cardiovascular risk in combination with PTSD. Evidence-based studies conducted between 2000 and 2021 were selected. RESULTS In total 1221 articles were identified and of these, 61 (48 original research papers, 13 review articles) were included in this review. Many, though not all, studies have reported increased activity of the sympathetic nervous system and decreased activity of the parasympathetic nervous system (namely, autonomic imbalance) in PTSD patients. There seems to be enough evidence to suggest impairments in baroreflex function in PTSD, leading to blood pressure dysregulation. It appears that the chronicity of PTSD diagnosis and symptom severity are independent risk factors for cardiovascular disease, which may be linked with impaired autonomic function. CONCLUSIONS Increased cardiovascular risk may be associated with autonomic dysfunction in PTSD. Whether autonomic dysfunction can serve as a biomarker for the onset and progression of PTSD remains to be determined. It also needs to determine if autonomic imbalance increases the risk of developing PTSD.
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Affiliation(s)
- Qi Fu
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas, Internal Medicine, University of Texas Southwestern Medical Center, Dallas, TX, United States of America.
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Costa MSA, Vilhena E, Leite Â, Almeida AC, Pereira MG. Quality of Life in Caregivers of Type 2 Diabetes Patients After Patient's Surgery: a Path Analysis. Int J Behav Med 2021; 29:438-447. [PMID: 34608592 DOI: 10.1007/s12529-021-10028-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/21/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND Type 2 diabetes Mellitus is a chronic disease, and one of its complications may result in amputation. The goal of this study was to evaluate the impact of psychosocial variables, over time, on quality of life (QoL) of caregivers of patients (N = 110) who had undergone a recent amputation. METHOD A longitudinal design was employed: (T1) 1 month after the patient's surgery; (T2) 7 months after; and (T3) 10 months after. Burden Assessment Scale, Family Assessment Device, Revised Impact of Events Scale, Family Disruption from Illness Scale, and Short Form Health Survey were used. A path analysis model was tested. RESULTS Burden, perception of family functioning, and traumatic symptoms at T1 showed a positive impact on the perception of family functioning, at T2. Traumatic symptoms, at T1, predicted traumatic symptoms at T2 being also a mediator between those symptoms (T1) and physical QoL (T3). Physical and traumatic symptoms, at T1 predicted physical symptoms, at T2 affecting both mental and physical QoL (T3), being also a mediator in these relationships. Burden (T1) also had a direct effect on mental QoL (T3) and at T2 had an impact on physical QoL (T3) mediating also the relationship between burden/physical symptoms at T1 and physical QoL, at T3. CONCLUSION Intervention should focus on physical and traumatic symptoms as well as burden since they were both mediators regarding mental and physical QoL.
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Affiliation(s)
- M Suely Alves Costa
- Research Center in Psychology (CIPsi), School of Psychology, University of Minho, Campus de Gualtar, 4710-245, Braga, Portugal
| | - Estela Vilhena
- 2Ai School of Technology, IPCA, 4750-810, Barcelos, Portugal
| | - Ângela Leite
- Research Center in Psychology (CIPsi), School of Psychology, University of Minho, Campus de Gualtar, 4710-245, Braga, Portugal
| | - Ana C Almeida
- Research Center in Psychology (CIPsi), School of Psychology, University of Minho, Campus de Gualtar, 4710-245, Braga, Portugal
| | - M Graça Pereira
- Research Center in Psychology (CIPsi), School of Psychology, University of Minho, Campus de Gualtar, 4710-245, Braga, Portugal.
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Cuevas AG, Ho T, Rodgers J, DeNufrio D, Alley L, Allen J, Williams DR. Developmental timing of initial racial discrimination exposure is associated with cardiovascular health conditions in adulthood. ETHNICITY & HEALTH 2021; 26:949-962. [PMID: 31064206 PMCID: PMC7026859 DOI: 10.1080/13557858.2019.1613517] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/03/2018] [Accepted: 04/26/2019] [Indexed: 05/24/2023]
Abstract
OBJECTIVE To examine the association between developmental timing of initial exposure to racial discrimination and cardiovascular health conditions. DESIGN Using data from the 1995 Detroit Area Study, logistic and negative binomial regression models were used to assess the association between timing of initial exposure to racial/ethnic discrimination, classified as early childhood (0-7), childhood (8-12), adolescence (13-19), and adulthood (>19), on physician-diagnosed cardiovascular health conditions during adulthood. Each analysis adjusted for age, gender, race/ethnicity, income, education, marital status, health-related behaviors, and pre-existing health conditions. RESULTS Of the 1,106 participants in the final sample, 520 identified as White and 586 identified as Black. Over half (64%) of the sample experienced at least one major cardiovascular health event at the time of the study, with 39% reporting two or more events. Results from logistic regression models showed that initial exposure to racial discrimination during early childhood was associated with a 2.96 (95%CI:1.15, 7.83) times greater odds of having any cardiovascular-related health condition later in life compared to individuals who reported no discrimination. Results from negative binomial regression models demonstrated that individuals who reported initial exposure to racial discrimination during early childhood and adolescence had a CVD incidence rate that was 1.63 (95%CI:1.11, 2.38) and 1.37 (95%CI:1.10, 1.69) times higher than individuals who reported no discrimination. CONCLUSION Initial exposure to racial discrimination in early childhood and adolescence may increase the risk of cardiovascular conditions later in life. Clinicians and researchers should consider racial discrimination during childhood as a possible risk factor for illness and disease.
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Affiliation(s)
- Adolfo G. Cuevas
- Department of Community Health, Tufts University, Medford, MA, USA
| | - Thao Ho
- Department of Community Health, Tufts University, Medford, MA, USA
| | - Justin Rodgers
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Danielle DeNufrio
- Department of Public Health and Community Medicine, Tufts’ School of Medicine, Boston, MA, USA
| | | | - Jennifer Allen
- Department of Community Health, Tufts University, Medford, MA, USA
| | - David R. Williams
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Department of African and African American Studies, Harvard University, Cambridge, MA, USA
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11
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Thomas CL, Nieh C, Hooper TI, Gackstetter GD, LeardMann CA, Porter B, Blazer DG. Sexual Harassment, Sexual Assault, and Physical Activity Among U.S. Military Service Members in the Millennium Cohort Study. JOURNAL OF INTERPERSONAL VIOLENCE 2021; 36:7043-7066. [PMID: 30827142 DOI: 10.1177/0886260519832904] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Sexual harassment (SH) and sexual assault (SA) continue to be a focus of prevention efforts in the U.S. military because of the prevalence and potential to affect the health and readiness of service members. Limited research exists on the association of SH and SA with coping behaviors, such as physical activity, within the military. Data including self-reported SA, SH, and physical activity were obtained from the Millennium Cohort Study, a longitudinal cohort study designed to examine the impact of military service on the health and well-being of service members. A hierarchical regression approach was applied to examine the association between SH or SA and subsequent physical activity levels. Hierarchical regression showed that, among those self-reporting recent SA, the odds of medium-high (300-449 min/week) and high physical activity levels (≥450 min/week) were significantly increased. Although the magnitude of these associations was attenuated with an increasing amount of adjustment, the odds of high physical activity levels remained statistically significant in the fully adjusted model (medium-high: odds ratio [OR] = 1.72, 95% confidence interval [CI] = [1.08, 2.73]; high: OR = 1.58, 95% CI = [1.02, 2.44]). We observed statistically significant negative associations between recent SH and medium-high physical activity levels in adjusted models (OR = 0.70, 95% CI = [0.54, 0.91]). The current results demonstrate that SA is generally associated with increased levels of physical activity among military service members. Analyzing the relationship between sexual trauma and physical activity is valuable because of the high prevalence of SH and SA in the military, long-term health implications including physical and emotional well-being, and potential impact on military readiness.
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Affiliation(s)
- Connie L Thomas
- Uniformed Services University of the Health Sciences, Bethesda, MD, USA
| | - Chiping Nieh
- Uniformed Services University of the Health Sciences, Bethesda, MD, USA
- The Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, MD, USA
| | - Tomoko I Hooper
- Uniformed Services University of the Health Sciences, Bethesda, MD, USA
| | | | - Cynthia A LeardMann
- The Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, MD, USA
| | - Ben Porter
- The Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, MD, USA
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Cohen CE, Barron IG. Trauma-Informed High Schools: A Systematic Narrative Review of the Literature. SCHOOL MENTAL HEALTH 2021. [DOI: 10.1007/s12310-021-09432-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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13
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Lathan EC, Selwyn CN, Langhinrichsen-Rohling J. The "3 Es" of trauma-informed care in a federally qualified health center: Traumatic Event- and Experience-related predictors of physical and mental health Effects among female patients. JOURNAL OF COMMUNITY PSYCHOLOGY 2021; 49:703-724. [PMID: 33301611 DOI: 10.1002/jcop.22488] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/09/2020] [Revised: 10/06/2020] [Accepted: 11/13/2020] [Indexed: 06/12/2023]
Abstract
Federally Qualified Health Centers (FQHCs) are a fast-growing source of healthcare for women with intersectional identities, or those most frequently exposed to and negatively impacted by interpersonal trauma. According to the "3 E" conceptualization of trauma, certain Event- and Experience-related characteristics of a trauma predict victims' physical and mental health Effects. The "3 Es" have yet to be studied in female FQHC patients. The current study examined the prevalence of interpersonal trauma and interrelationships among traumatic Event-related factors (e.g., cumulative trauma by victim-perpetrator relationship), Experience-related factors (e.g., betrayal, resilience), and Effects (e.g., somatic symptoms, posttraumatic stress (PTS), anxiety/depression, mistrust, reduced sense of safety) among 138 predominantly Black (89.1%) women receiving care at an FQHC in the southeastern U.S. Roughly 65% of participants (n = 86) endorsed exposure to at least one type of interpersonal trauma. More cumulative trauma was significantly correlated with more somatic, PTS, and anxious/depressive symptoms, and a reduced sense of safety. Experiences of betrayal and/or resilience were better predictors of PTS and anxious/depressive symptoms and lack of safety than Event-related factors. Findings support the need for the implementation of trauma-informed care within community-based health centers. Healthcare providers should consider women's subjective experience of trauma when screening for exposure and providing trauma-sensitive care.
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Affiliation(s)
- Emma C Lathan
- Department of Psychiatry and Behavioral Sciences, The University of Texas Health Science Center at Houston, Houston, Texas, USA
- Department of Psychology, University of South Alabama, Mobile, Alabama, USA
| | - Candice N Selwyn
- Department of Community Mental Health Nursing, University of South Alabama, Mobile, Alabama, USA
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Trautwein B, Merz T, Denoix N, Szabo C, Calzia E, Radermacher P, McCook O. ΔMST and the Regulation of Cardiac CSE and OTR Expression in Trauma and Hemorrhage. Antioxidants (Basel) 2021; 10:233. [PMID: 33546491 PMCID: PMC7913715 DOI: 10.3390/antiox10020233] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Revised: 02/01/2021] [Accepted: 02/01/2021] [Indexed: 12/19/2022] Open
Abstract
Genetic deletion of 3-mercaptopyruvate sulfurtransferase (MST) is known to result in hypertension and cardiac hypertrophy in older mice, and is associated with increased anxiety-like behaviors. Endogenous hydrogen sulfide (H2S) produced by MST in the mitochondria is also known to be involved in physiological and cellular bioenergetics, and its dysfunction associated with depressive behavior and increased cardiovascular morbidity. Interestingly, early life stress has been shown to lead to a significant loss of cystathionine-γ-lyase (CSE) and oxytocin receptor (OTR) expression in the heart. Thus, we were interested in testing the hypothesis of whether genetic MST mutation (ΔMST) would affect cardiac CSE and OTR expression and affect the mitochondrial respiration in a clinically relevant, resuscitated, mouse model of trauma and hemorrhagic shock. In ΔMST mice, we found a reduction of CSE and OTR in both the naive as well as injured state, in contrast to the wild type (wt) controls. Interestingly, the ΔMST showed a different complex IV response to injury than the wt controls, although our claims are based on the non-demonstrated assumption that naive wt and naive ΔMST mice have comparable complex IV activity. Finally, hemorrhagic shock led to a reduction of CSE and OTR, confirming previous results in the injured mouse heart. To date, the exact mechanisms of the cardiac interaction between H2S and OT are not clear, but they point the way to potential cardioprotective therapies.
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Affiliation(s)
- Britta Trautwein
- Institute for Anesthesiological Pathophysiology and Process Engineering, Ulm University Medical Center, 89081 Um, Germany; (B.T.); (T.M.); (N.D.); (E.C.); (P.R.)
| | - Tamara Merz
- Institute for Anesthesiological Pathophysiology and Process Engineering, Ulm University Medical Center, 89081 Um, Germany; (B.T.); (T.M.); (N.D.); (E.C.); (P.R.)
| | - Nicole Denoix
- Institute for Anesthesiological Pathophysiology and Process Engineering, Ulm University Medical Center, 89081 Um, Germany; (B.T.); (T.M.); (N.D.); (E.C.); (P.R.)
- Clinic for Psychosomatic Medicine and Psychotherapy, Ulm University Medical Center, 89070 Ulm, Germany
| | - Csaba Szabo
- Department of Science and Medicine, University of Fribourg, 1700 Fribourg, Switzerland;
| | - Enrico Calzia
- Institute for Anesthesiological Pathophysiology and Process Engineering, Ulm University Medical Center, 89081 Um, Germany; (B.T.); (T.M.); (N.D.); (E.C.); (P.R.)
| | - Peter Radermacher
- Institute for Anesthesiological Pathophysiology and Process Engineering, Ulm University Medical Center, 89081 Um, Germany; (B.T.); (T.M.); (N.D.); (E.C.); (P.R.)
| | - Oscar McCook
- Clinic for Psychosomatic Medicine and Psychotherapy, Ulm University Medical Center, 89070 Ulm, Germany
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15
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Petrović-Lazić M, Ilić-Savić I. Prevalence, etiology and treatment of psychogenic aphonia in children: A case report. PRAXIS MEDICA 2021. [DOI: 10.5937/pramed2104007p] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
Introduction. Emotions are one of the most important psychological processes, with a decisive influence on a person's voice. Faced with the great challenges and changes that primary and secondary socialization agents impose in the process of growing up, children consequently experience a spectrum of various unpleasant feelings: anxiety, fear, anger, frustration and sadness. Due to the fast-paced lifestyle, it often happens that the child ignores unpleasant feelings, which further worsens the condition in which he finds himself. Among other conditions, psychogenic aphonia in children has become more frequent in recent years. The current case report aims to determine the frequency of psychogenic aphonia in children, to identify the most common causes that lead to psychogenic aphonia and highlight the methods of vocal treatment that give the best results during rehabilitation. Case report. The current paper presents the results collected in a two-year period at the Clinic for Ear, Throat and Nose of the Clinical Hospital Center "Zvezdara". In the period from March 2017 to May 2019, psychogenic aphonia was diagnosed in 31 patients, which is an evident increase compared to the previous ten-year period in which psychogenic aphonia was diagnosed in 38 younger patients. Analyzing heteroanamnestic data obtained from parents, the most common answer about the cause of psychogenic aphonia is dissatisfaction with school success. After successful diagnostics by an otorhinolaryngologist, psychiatrist and vocal pathologist, in the process of rehabilitation of psychogenic aphonia, methods of digital manipulation of the larynx, methods of restoring the voice with cough reflex and methods of turning out the feedback system were applied. In this particular case, the method of digital manipulation of the larynx gave the best results. Conclusion. Optimal evaluation of patients with voice disorders requires the joint efforts of experts from different disciplines. Having in mind the tendency of recurrence of psychogenic aphonia, these findings suggest that the integration of the interventions of a vocal pathologist and a psychiatrist could give effective results in the process of rehabilitation voice.
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16
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Latour C, O'Byrne L, McCarthy M, Chacko R, Russell E, Price RK. Improving mental health in U.S. Veterans using mHealth tools: A pilot study. Health Informatics J 2020; 26:3201-3214. [PMID: 32972313 PMCID: PMC8112186 DOI: 10.1177/1460458220954613] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Rates of PTSD remain elevated among U.S. Veterans, highlighting a need for innovative management tools. Previous studies have shown mobile apps to have positive effects on PTSD symptoms, but few apps have been examined systematically. This pilot study evaluated the perceived effectiveness and usability of Mindset, a novel mobile app that monitors user stress level via heart rate to encourage e-therapy use. The study sample included 30 community-residing Veterans who completed baseline assessments. They used the Mindset app and associated smartwatch until their approximate 1-month follow-up. Self-reported assessments included pre- and post-deployment experiences; experience with Mindset; and standard screeners for PTSD (PCL-M), anxiety (GAD-7), depression (PHQ-9), and alcohol use problems (AUDIT). Among the 24 participants who completed follow-up interviews, a significant decrease (p < 0.05) was found in PCL-M, PHQ-9, and modified AUDIT scores. Respondents reported moderate to high acceptance and satisfaction with Mindset features, though considerable frustration with the associated smartwatch. These findings highlight mHealth apps such as Mindset as potentially useful tools for PTSD and depression symptom management. These findings are also encouraging in the context of the current COVID-19 pandemic, which may accelerate further innovation and implementation of mHealth technologies to improve mental health self-care.
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Affiliation(s)
- Chase Latour
- Washington University in St. Louis, USA
- University of North Carolina at Chapel Hill
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17
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Rafiq T, O’Leary DD, Dempster KS, Cairney J, Wade TJ. Adverse Childhood Experiences (ACEs) Predict Increased Arterial Stiffness from Childhood to Early Adulthood: Pilot Analysis of the Niagara Longitudinal Heart Study. JOURNAL OF CHILD & ADOLESCENT TRAUMA 2020; 13:505-514. [PMID: 33269049 PMCID: PMC7683677 DOI: 10.1007/s40653-020-00311-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
An association among adults between adverse childhood experiences (ACEs) and arterial stiffness and between arterial stiffness and cardiovascular disease has been established. Recent cross-sectional evidence suggests that ACEs is linked to the development and progression of arterial stiffness, but it remains unclear when these changes begin to manifest. We examine the relationship between ACEs and changes in arterial stiffness from childhood into adulthood using population-based longitudinal data. The Niagara Longitudinal Heart Study (NLHS) pilot data included 76 young adults (females = 44), with an average age of 21 years (SD = 1), and had a follow-up period of 9 years. Mixed effects modeling was used to examine the effect of ACEs on changes in arterial stiffness over time adjusting for sex, changes in heart rate, systolic blood pressure, body mass index, and physical activity. Individuals with four or more ACEs have a greater increase in arterial stiffness over time from childhood into young adulthood. This increase was similar for both males and females and independent of the effects of change in heart rate, systolic blood pressure, body mass index, and physical activity. Exposure to ACEs is associated with greater increase in arterial stiffness, a marker for cardiovascular disease among adults. This suggests that interventions targeted at individuals with high exposure to ACEs early on in life could lower the risk of arterial stiffness and in turn the cascade of events leading to cardiovascular disease.
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Affiliation(s)
- Talha Rafiq
- Department of Health Sciences, Faculty of Applied Health Sciences, Brock University, St. Catharines, Ontario Canada
| | - Deborah D. O’Leary
- Department of Health Sciences, Faculty of Applied Health Sciences, Brock University, St. Catharines, Ontario Canada
- Brock-Niagara Centre for Health and Well-Being, Brock University, St. Catharines, Ontario Canada
| | - Kylie S. Dempster
- Department of Health Sciences, Faculty of Applied Health Sciences, Brock University, St. Catharines, Ontario Canada
- Brock-Niagara Centre for Health and Well-Being, Brock University, St. Catharines, Ontario Canada
| | - John Cairney
- School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, Queensland Australia
| | - Terrance J. Wade
- Department of Health Sciences, Faculty of Applied Health Sciences, Brock University, St. Catharines, Ontario Canada
- Brock-Niagara Centre for Health and Well-Being, Brock University, St. Catharines, Ontario Canada
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18
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Glynn TR, Mendez NA, Jones DL, Dale SK, Carrico AW, Feaster DJ, Rodriguez AE, Safren SA. Trauma exposure, PTSD, and suboptimal HIV medication adherence among marginalized individuals connected to public HIV care in Miami. J Behav Med 2020; 44:147-158. [PMID: 33098541 DOI: 10.1007/s10865-020-00191-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Accepted: 10/08/2020] [Indexed: 11/25/2022]
Abstract
Individuals living with HIV report disproportionately high levels of trauma exposure and PTSD symptoms, both which have been associated with suboptimal ART adherence. Often conflated, the question arises as to which construct is driving subsequent HIV self-care behavior. Given the HIV disparities among Black and Hispanic/Latinx individuals, and that Miami is a geographic region with a high racial/ethnic minority make up and a unique socioeconomic environment, it is important to explore factors related to HIV outcomes in Miami to mitigate its uncontrolled epidemic. This study aimed to examine the association of trauma exposure, PTSD symptoms, and relevant additional key factors with adherence to ART among a sample of majority Black and Hispanic/Latinx individuals who are economically marginalized receiving public HIV care in Miami, FL (N = 1237) via a cross-sectional survey. Sequential linear regression was used to examine the study aim in four blocks: (1) trauma, (2) PTSD symptoms, and key covariates of ART adherence including (3) depression and substance use (potential psychological covariates), and (4) indicators of socioeconomic status (potential structural covariates). In the first block, trauma exposure was associated with worse adherence. However, in the second block, the association with trauma dropped and PTSD was significantly associated with worse adherence. Of note, for those experiencing high levels of trauma exposure, adherence was negatively impacted regardless of PTSD. When other key factors associated with adherence were entered in the third and fourth blocks, neither trauma exposure nor PTSD were uniquely significant. In this final model, depression, substance use, and unstable housing were uniquely associated with worse adherence. Trauma-informed models of HIV care that holistically address co-occurring factors are warranted to cater to communities with HIV health disparities and keep them from falling off the HIV care continuum.
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Affiliation(s)
- Tiffany R Glynn
- Department of Psychology, University of Miami Miller School of Medicine, Clinical Research Building, 1120 NW 14th St., Miami, FL, 33136, USA
| | - Noelle A Mendez
- Department of Psychology, University of Miami Miller School of Medicine, Clinical Research Building, 1120 NW 14th St., Miami, FL, 33136, USA
| | - Deborah L Jones
- Department of Psychiatry and Behavioral Sciences, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Sannisha K Dale
- Department of Psychology, University of Miami Miller School of Medicine, Clinical Research Building, 1120 NW 14th St., Miami, FL, 33136, USA
| | - Adam W Carrico
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Daniel J Feaster
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Allan E Rodriguez
- Division of Infectious Disease, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Steven A Safren
- Department of Psychology, University of Miami Miller School of Medicine, Clinical Research Building, 1120 NW 14th St., Miami, FL, 33136, USA.
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19
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Reyes-Ortiz CA, Perez-Zepeda MU, Ocampo-Chaparro JM, Campo-Arias A, Borda MG, Holmes HM, Luque JS. Polyvictimization and Recurrent Falling in Older Ecuadorian Adults: The Mediation Role of Depressive Symptoms. J Aging Health 2020; 33:27-38. [PMID: 32877294 DOI: 10.1177/0898264320952916] [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: 12/21/2022]
Abstract
Objective: To assess depressive symptoms as a mediator in the association between polyvictimization and recurrent falling. Methods: Using data from the Salud, Bienestar y Envejecimiento (Health, Well-being, and Aging) Ecuador Study, we analyzed community-dwelling adults 60 years and older (n = 5227). Recurrent falling was determined as ≥2 falls during the prior 12 months. Polyvictimization was determined as a history of ≥2 types of abuse. The mediator was depressive symptoms. Mediation analyses were based on the VanderWeele method. Results: Polyvictimization was significantly associated with higher odds of recurrent falling, and odds ratio (OR) = 1.45 (95% confidence intervals [CI] 1.20-1.76). Higher depressive symptoms increase the odds for recurrent falling (OR = 1.09 and 95% CI 1.07-1.11). Moreover, depressive symptoms were a significant mediator between polyvictimization and recurrent falling. The mediating effect was 28.4%. Discussion: Polyvictimization was associated with higher odds of recurrent falling, and this association was mediated by depressive symptoms.
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Affiliation(s)
- Carlos A Reyes-Ortiz
- Institute of Public Health, College of Pharmacy and Pharmaceutical Sciences, 15467Florida A&M University, FL, USA
| | - Mario U Perez-Zepeda
- Geriatric Medicine Research, Nova Scotia Health Authority, 12361Dalhousie University, Canada.,Semillero de Neurociencias y Envejecimiento, Instituto de Envejecimiento, Facultad de Medicina, 27964Pontificia Universidad Javeriana, Colombia.,233936Instituto Nacional de Geriatría, Mexico.,Centro de Investigación en Ciencias de la Salud (CICSA), FCS, 27753Universidad Anáhuac México Campus Norte, México
| | - José M Ocampo-Chaparro
- 28006Universidad del Valle, Colombia.,Grupo Interinstitucional de Medicina Interna (GIMI 1), 67637Universidad Libre, Colombia
| | - Adalberto Campo-Arias
- Programa de Medicina, Facultad de Ciencias de la Salud, 469579Universidad del Magdalena, Colombia
| | - Miguel G Borda
- Semillero de Neurociencias y Envejecimiento, Instituto de Envejecimiento, Facultad de Medicina, 27964Pontificia Universidad Javeriana, Colombia.,Centre for Age-Related Medicine (SESAM), 60496Stavanger University Hospital, Norway.,Faculty of Health Sciences, 56627University of Stavanger, Norway
| | - Holly M Holmes
- McGovern Medical School, Geriatric and Palliative Medicine Division, 12339University of Texas Health Science Center at Houston, TX, USA
| | - John S Luque
- Institute of Public Health, College of Pharmacy and Pharmaceutical Sciences, 15467Florida A&M University, FL, USA
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20
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Fimiani R, Gazzillo F, Fiorenza E, Rodomonti M, Silberschatz G. Traumas and Their Consequences According to Control-Mastery Theory. Psychodyn Psychiatry 2020; 48:113-139. [PMID: 32628581 DOI: 10.1521/pdps.2020.48.2.113] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
The aim of this article is to introduce the reader to how control-mastery theory (CMT; Gazzillo, 2016; Silberschatz, 2005; Weiss, 1993), an integrative relational cognitive-dynamic theory of mental functioning, psychopathology, and psychotherapeutic process, understands traumas, their consequences, and their mastery. In the first part of this article, we will present an overview of the debate about the definition of trauma within the different editions of the Diagnostic and Statistical Manual of Mental Disorders. Then, we will focus on the concept of complex traumas and on their consequences on mental health. Finally, we will discuss how CMT conceptualizes traumas and their pathological consequences. We will stress in particular how, according to CMT, in order for a painful experience to become a trauma, its victim has to come to believe that s/he caused it in the attempt to pursue a healthy and adaptive goal. In order to master traumas and disprove the pathogenic beliefs developed from them, people attempt to reexperience situations similar to the traumatic ones in safer conditions while giving them happier endings.
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Affiliation(s)
- Ramona Fimiani
- Department of Dynamic and Clinical Psychology "Sapienza" University of Rome
| | - Francesco Gazzillo
- Department of Dynamic and Clinical Psychology "Sapienza" University of Rome
| | - Eleonora Fiorenza
- Department of Dynamic and Clinical Psychology "Sapienza" University of Rome
| | - Martina Rodomonti
- Department of Dynamic and Clinical Psychology "Sapienza" University of Rome
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21
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Ge F, Yuan M, Li Y, Zhang W. Posttraumatic Stress Disorder and Alterations in Resting Heart Rate Variability: A Systematic Review and Meta-Analysis. Psychiatry Investig 2020; 17:9-20. [PMID: 31995968 PMCID: PMC6992856 DOI: 10.30773/pi.2019.0112] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2019] [Accepted: 10/14/2019] [Indexed: 02/08/2023] Open
Abstract
OBJECTIVE The functions of both the central and peripheral autonomic nervous system, indexed by heart rate variability (HRV), are affected by psychology and physiology. This review summarizes the results of studies comparing the evaluation of HRV parameters between individuals with posttraumatic stress disorder (PTSD) and healthy controls. METHODS Eligible studies (n=499) were identified through literature searches of the EMBASE, Medline, PubMed and Web of Science databases. Nineteen studies met our inclusion criteria. A random effects model was used, and standardized mean differences for highfrequency HRV(HF-HRV), low-frequency HRV(LF-HRV) and the root mean square of successive R-R interval differences (RMSSD) were calculated. RESULTS Significant effects were found for HF-HRV [p<0.0001, Z=4.18; Hedges'g=-1.58, 95% confidence interval (CI) (-2.32, -0.84); k=14] and RMSSD [p<0.00001, Z=4.80; Hedges'g=-1.96, 95% CI (-2.76, -1.16); k=9] relative to healthy controls. Considerable heterogeneity was revealed, but the main effects for HF-HRV and RMSSD were robust in subsequent meta-regression and subgroup analyses. CONCLUSION Given the relationships among low vagal state, inflammation, and alterations in brain structure and function, including executive function and emotion regulation, reduced HRV may be regarded as an endophenotype in PTSD research.
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Affiliation(s)
- Fenfen Ge
- Mental Health Center of West China Hospital, Sichuan University, Chengdu, China
| | - Minlan Yuan
- Mental Health Center of West China Hospital, Sichuan University, Chengdu, China
| | - Ying Li
- Embedded System and Intelligent Computing Laboratory, University of Electronic Science and Technology of China, Chengdu, China
| | - Wei Zhang
- Mental Health Center of West China Hospital, Sichuan University, Chengdu, China
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22
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Pedras S, Vilhena E, Carvalho R, Pereira MG. Quality of Life Following a Lower Limb Amputation in Diabetic Patients: A Longitudinal and Multicenter Study. Psychiatry 2020; 83:47-57. [PMID: 31652411 DOI: 10.1080/00332747.2019.1672438] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Objective: Lower limb amputation (LLA) leads to several emotional and physical sequelaes that have a negative impact on individuals` life. The objectives of this study were: 1) to analyze the relationship between emotional reactions (anxiety, depression and traumatic stress symptoms) and functionality level, before and after a LLA due to diabetic foot ulcer, and mental/physical quality of life; and 2) to analyze the mediator role of social support between emotional reactions and mental/physical quality of life. Method: A multicenter, longitudinal study with four time assessments: before the surgery, one month, six months, and ten months after surgery, including 206 individuals hospitalized with diabetic foot ulcer indicated for a LLA. The instruments used were the following: Revised Impact of Event Scale; Barthel Index; Hospital Anxiety and Depression Scale and SF-36. Results: Anxiety symptoms before surgery and depression symptoms one month after surgery contribute to Mental Component Score (MCS) ten months after surgery. The level of functionality before and one month after surgery, traumatic stress symptoms one month after surgery as well as satisfaction with social support six months after surgery contribute to the Physical Component Score (PCS), ten months after surgery. Social support was a mediator between traumatic stress symptoms one month after surgery and PCS ten months after surgery. Conclusion: Identifying risk variables and the extent to which and when they affect mental/physical quality of life, will help to develop appropriate psychological interventions to promote quality of life in this population.
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23
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Christian-Brandt AS, Santacrose DE, Farnsworth HR, MacDougall KA. When Treatment is Traumatic: An Empirical Review of Interventions for Pediatric Medical Traumatic Stress. AMERICAN JOURNAL OF COMMUNITY PSYCHOLOGY 2019; 64:389-404. [PMID: 31617588 DOI: 10.1002/ajcp.12392] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Pediatric medical traumatic stress (PMTS) is common among injured/ill children and is associated with elevated distress, treatment non-adherence, and poor health outcomes. As survivorship of life-threatening pediatric injury and illness continues to increase alongside rapid medical advancements, rates of PMTS and negative sequelae are expected to grow; however, research on prevention and treatment of PMTS is limited. The current study sought to systematically review the literature using a developmental framework to highlight research gaps. Sixteen peer-reviewed studies were identified via a systematic literature search. Consistent with best practices for treatment of childhood trauma, caregiver involvement and CBT principles served as the foundation for most interventions. All studies reported improvements in PMTS; however, among the most methodologically rigorous, few found statistically superior reductions in PMTS between intervention and control groups. While many studies focused on a specific developmental stage and discussed developmental considerations, others took a "one-size-fits" approach. Interventions that demonstrated the most promising findings were online, self-guided, or time-limited. Future research would benefit from expanding diversity of participants, continuing to evaluate novel delivery methods, and integrating developmental considerations along with trauma-informed care (TIC) approaches, given their useful framework for understanding child traumatic stress responses and avenues for prevention and treatment.
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24
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Goyal NG, Maddocks KJ, Johnson AJ, Byrd JC, Westbrook TD, Andersen BL. Cancer-Specific Stress and Trajectories of Psychological and Physical Functioning in Patients With Relapsed/Refractory Chronic Lymphocytic Leukemia. Ann Behav Med 2019; 52:287-298. [PMID: 30084895 DOI: 10.1093/abm/kax004] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Background Chronic lymphocytic leukemia is the most prevalent adult leukemia. The disease is incurable with a cycling of treatment and relapse common. Little is known about the psychological and physical functioning of patients with relapsed/refractory chronic lymphocytic leukemia. Cancer-specific stress is an important individual difference variable that predicts psychological and physical outcomes. Purpose To examine cancer-specific stress at treatment initiation as a predictor of psychological and physical functioning trajectories in patients with relapsed/refractory chronic lymphocytic leukemia during the first 5 months of treatment. Methods Patients with relapsed/refractory chronic lymphocytic leukemia (N = 152) enrolled in a phase II clinical trial completed self-report measures at treatment initiation (baseline), 1, 2, and 5 months of treatment. Cancer-specific stress at baseline was examined as a predictor of psychological (cognitive-affective depressive symptoms, negative mood, mental health quality of life) and physical functioning (fatigue interference, sleep problems, physical health quality of life), controlling for demographic and treatment variables. Results Using multilevel modeling, higher baseline cancer-specific stress was related to worse psychological (cognitive-affective depressive symptoms, negative mood, mental health quality of life) and physical functioning (fatigue interference, sleep problems) at baseline and more rapid improvements during the next 5 months. Despite these improvements, higher baseline cancer-specific stress remained associated with poorer 5-month psychological, though not physical, functioning. Conclusions Findings suggest cancer-specific stress at treatment initiation may be a risk factor for poorer psychological functioning during treatment for patients with relapsed/refractory chronic lymphocytic leukemia.
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Affiliation(s)
- Neha G Goyal
- Department of Social Sciences and Health Policy, Wake Forest School of Medicine, Medical Center Boulevard, Winston-Salem, NC
| | - Kami J Maddocks
- Division of Hematology, Department of Internal Medicine, The Ohio State University Medical Center, Columbus, OH
| | - Amy J Johnson
- Division of Hematology, Department of Internal Medicine, The Ohio State University Medical Center, Columbus, OH
| | - John C Byrd
- Division of Hematology, Department of Internal Medicine, The Ohio State University Medical Center, Columbus, OH
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25
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Rizkalla N, Segal SP. Trauma during humanitarian work: the effects on intimacy, wellbeing and PTSD-symptoms. Eur J Psychotraumatol 2019; 10:1679065. [PMID: 31692832 PMCID: PMC6818129 DOI: 10.1080/20008198.2019.1679065] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2019] [Revised: 08/30/2019] [Accepted: 09/06/2019] [Indexed: 12/13/2022] Open
Abstract
Background: Organizations assisting refugees are over burdened with the Syrian humanitarian catastrophe and encounter diverse difficulties facing the consequences of this massive displacement. Aid-workers experience the horrors of war through their efforts to alleviate suffering of Syrian refugees. Objective: This study of Syrian refugee aid-workers in Jordan examined work-stressors identified as secondary traumatic stress (STS), number of refugees assisted, worker feelings towards the organization, and their associations to PTSD-symptoms, wellbeing and intimacy. It also examined whether self-differentiation, physical health, and physical pain were associated with these variables. Method: Syrian refugee aid-workers (N = 317) in Jordan's NGOs were surveyed. Univariate statistics and structural equation modeling (SEM) were utilized to test study hypotheses. Results: Increased STS was associated with lower self-differentiation, decreased physical health and increased physical pain, as well as elevated PTSD-symptoms and decreased intimacy. Decreased connection to the NGO was associated with lower self-differentiation, decreased physical health, increased physical pain, and with decreased intimacy and wellbeing. Lower self-differentiation was associated with increased PTSD-symptoms, decreased wellbeing and intimacy. Elevated physical pain was associated with increased PTSD-symptoms, and decreased wellbeing. Diverse mediation effects of physical health, physical pain and self-differentiation were found among the study's variables. Conclusions: Aid-workers who assist refugees were at risk of physical and mental sequelae as well as suffering from degraded self-differentiation, intimacy and wellbeing. Organizations need to develop prevention policies and tailor interventions to better support their aid-workers while operating in such stressful fieldwork.
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Affiliation(s)
- Niveen Rizkalla
- Mack Center on Mental Health & Social Conflict, School of Social Welfare, University of California Berkeley, Berkeley, CA, USA
| | - Steven P. Segal
- School of Social Welfare, University of California, Berkeley, CA, USA
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O'Brien KH. Social determinants of health: the how, who, and where screenings are occurring; a systematic review. SOCIAL WORK IN HEALTH CARE 2019; 58:719-745. [PMID: 31431190 DOI: 10.1080/00981389.2019.1645795] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/17/2023]
Abstract
Screening for social determinants of health allows health care teams to assess and address social factors that influence one's health, mental health, and access to care. These social factors include poverty, health literacy, social support, exposure to trauma, food insecurity, and housing instability. The objective of this study was to examine what screening tools for social determinants of health are being used, in what contexts, and with what populations. Findings suggest that health literacy is the most commonly screened for, followed by trauma history, social support, food insecurity and housing across diverse contexts and populations. Results from this study can be used to inform providers of available screening tools and resources that can be readily utilized in practice.
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Affiliation(s)
- Kyle H O'Brien
- School of Health and Human Services, Department of Social Work, Southern Connecticut State University , New Haven , CT , USA
- Department of Health and Movement Sciences, Southern Connecticut State University , New Haven , CT , USA
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Wade TJ, O'Leary DD, Dempster KS, MacNeil AJ, Molnar DS, McGrath J, Cairney J. Adverse childhood experiences (ACEs) and cardiovascular development from childhood to early adulthood: study protocol of the Niagara Longitudinal Heart Study. BMJ Open 2019; 9:e030339. [PMID: 31315878 PMCID: PMC6661634 DOI: 10.1136/bmjopen-2019-030339] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
INTRODUCTION Recent reviews have found substantial links between a toxic childhood environment including child abuse and severe household dysfunction and adult cardiovascular disease (CVD). Collectively referred to as adverse childhood experiences (ACEs), this toxic environment is prevalent among children, with recent Canadian estimates of child abuse at 27%-32%, and severe household dysfunction at 49%. Based on these prevalence rates, the potential effect of ACEs on CVD is more significant than previously thought. Yet, how ACEs amplify the risk for later CVD remains unclear. Lifestyle risk factors only partially account for this connection, instead directing attention to the interaction between psychosocial factors and physiological mechanisms such as inflammation. The Niagara Longitudinal Heart Study (NLHS) examines how ACEs influence cardiovascular health (CVH) from childhood to early adulthood. Integrating the stress process and biological embedding models, this study examines how psychosocial and physiological factors in addition to lifestyle factors explain the relationship between ACEs and CVH. METHODS This follow-up study combines three baseline studies from 2007 to 2012 that collected CVH measures including child blood pressure, heart rate, left ventricular structure and function, arterial stiffness indices and baroreflex sensitivity on 564 children. Baseline data also include anthropometric, biological, lifestyle, behavioural, and psychosocial measures that varied across primary studies. Now over 18 years of age, we will recruit and retest as many participants from the baseline studies as possible collecting data on ACEs, CVH, anthropometric, lifestyle and psychosocial measures as well as blood, saliva and hair for physiological biostress markers. ETHICS AND DISSEMINATION Ethics approval has been received for the NLHS follow-up. Written consent to participate in the follow-up study is obtained from each participant. Results testing all proposed hypotheses will be submitted for publication in peer-reviewed journals.
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Affiliation(s)
- Terrance J Wade
- Health Sciences, Brock University, St. Catharines, Ontario, Canada
- Brock-NIagara Centre for Health and Well-Being, Brock University, St. Catharines, Ontario, Canada
- Child and Youth Studies, Brock University, St. Catharines, Ontario, Canada
| | - Deborah D O'Leary
- Health Sciences, Brock University, St. Catharines, Ontario, Canada
- Brock-NIagara Centre for Health and Well-Being, Brock University, St. Catharines, Ontario, Canada
| | - Kylie S Dempster
- Health Sciences, Brock University, St. Catharines, Ontario, Canada
- Brock-NIagara Centre for Health and Well-Being, Brock University, St. Catharines, Ontario, Canada
| | - Adam J MacNeil
- Health Sciences, Brock University, St. Catharines, Ontario, Canada
| | - Danielle S Molnar
- Child and Youth Studies, Brock University, St. Catharines, Ontario, Canada
| | - Jennifer McGrath
- Department of Psychology, Concordia University, Montreal, Quebec, Canada
| | - John Cairney
- Faculty of Kinesiology and Physical Education, University of Toronto, Toronto, Ontario, Canada
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Glass O, Dreusicke M, Evans J, Bechard E, Wolever RQ. Expressive writing to improve resilience to trauma: A clinical feasibility trial. Complement Ther Clin Pract 2019; 34:240-246. [DOI: 10.1016/j.ctcp.2018.12.005] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2018] [Revised: 11/17/2018] [Accepted: 12/13/2018] [Indexed: 11/27/2022]
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Goldstein E, Murray-García J, Sciolla AF, Topitzes J. Medical Students' Perspectives on Trauma-Informed Care Training. Perm J 2018; 22:17-126. [PMID: 29401053 DOI: 10.7812/tpp/17-126] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
INTRODUCTION Adults exposed to traumatic events during childhood commonly seek medical services, but health care practitioners hesitate to address and assess early trauma despite its known negative health effects. This study examines medical students' perspectives on a brief course that addressed the health care needs of patients exposed to adverse childhood experiences. METHODS A convenience sample of 20 University of California, Davis medical students from the Summer Institute on Race and Health received 6 hours of trauma-informed care training. The course was delivered in 2-hour modules during the course of 3 days, and included lectures, discussions, and practice. A questionnaire assessing students' perspectives on training benefits, current practice challenges, and necessary resources to provide trauma-informed medical care was distributed posttraining. RESULTS From the students' perspectives, this course increased their ability to recognize various clinical manifestations of adverse childhood experience exposure in adult patients. Students said they learned how to ask about and respond to adverse childhood experience disclosures and identify necessary resources to responsibly implement trauma-informed care in medical settings. Students identified provision of adequate resources and links to appropriate treatment identified as common challenges in providing health care to trauma-affected patients. CONCLUSION Study findings illustrate that trauma training can fill a knowledge gap and provide associated benefits for medical students. Initial training may pique students' interest by demonstrating the relevance of trauma knowledge in clinical practice; additional training likely is needed to support skills and confidence.
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Affiliation(s)
- Ellen Goldstein
- Postdoctoral Fellow at the University of Wisconsin-Madison Department of Family Medicine and Community Health Primary Care Research Fellowship.
| | - Jann Murray-García
- Assistant Health Sciences Clinical Professor at the Betty Irene Moore School of Nursing at the University of California, Davis.
| | - Andrés F Sciolla
- Associate Professor of Clinical Psychiatry in the Department of Psychiatry and Behavioral Sciences at the University of California, Davis.
| | - James Topitzes
- Associate Professor at the Helen Bader School of Social Welfare at the University of Wisconsin-Milwaukee and the Clinical Director of the Institute for Child and Family Well-Being.
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Altawil MAS, El Asam A, Khadaroo A. The Effectiveness of Therapeutic and Psychological Intervention Programs in PTC-GAZA. JOURNAL OF CHILD & ADOLESCENT TRAUMA 2018; 11:473-486. [PMID: 32318169 PMCID: PMC7163884 DOI: 10.1007/s40653-018-0213-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
The wars on Gaza (2008, 2012 & 2014) have left thousands of children and adults exposed to traumatic events (UNICEF, 2017). This study seeks to study and compare the usefulness of three different intervention programs, namely Therapeutic, Psycho-social support and Focusing. These interventions have been developed based on a holistic and integrated approach aimed at empowering resilience among Palestinian patients with Posttraumatic Stress Disorder (PTSD). PTSD was assessed through a validated scale developed by Altawil (2016). The aforementioned interventions were found to be successful: a) In the Family Therapy Programme (FTP), PTSD diagnosis reduced from 82% before intervention to 20% after intervention; b) In the Community Wellness Focusing Programme (CWF), PTSD diagnosis reduced from 97% before intervention to 19% after intervention; c) In the Psycho-Social Support Programme (SANID), PTSD diagnosis reduced from 50% before intervention to only 14% after intervention. Establishing the impact of interventions can be difficult without good tools for evaluation or assessment. Therefore, PTSD scales must consider culture, specific needs and the context of trauma exposure using both quantitative and qualitative assessment tools. Future tools should examine On-going Traumatic Stress Disorder (OTSD) so that it reflects on-going conflict and trauma in war-torn environments worldwide.
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Affiliation(s)
- Mohamad A. S. Altawil
- Clinical Psychologist (Registered by HCPC), in Green Branch Clinic Psychotherapy Practice (GBCPP), Cambridge, Hatfield, London, UK, https://www.gbclinic.com
- Projects Supervisor in Palestine Trauma Centre (UK), 4 Tanners Crescent, Hertford, Hertfordshire, UK, https://www.ptcuk.org
| | - Aiman El Asam
- Department of Psychology, Kingston University London, Kingston-Upon-Thames, UK
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Vidal C, Polo R, Alvarez K, Falgas-Bague I, Wang Y, Lê Cook B, Alegría M. Co-Occurrence of Posttraumatic Stress Disorder and Cardiovascular Disease Among Ethnic/Racial Groups in the United States. Psychosom Med 2018; 80:680-688. [PMID: 29781946 PMCID: PMC6113076 DOI: 10.1097/psy.0000000000000601] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
OBJECTIVE Trauma and/or symptoms of posttraumatic stress disorder (PTSD) have been linked to the onset of cardiovascular disease (CVD), but the exact mechanism has not been determined. We examine whether the risk of CVD is different among those who have a history of trauma without PTSD symptoms, those who have experienced trauma and developed any symptoms of PTSD, and those with a PTSD diagnosis. Furthermore, we examine whether this association varies across ethnic/racial groups. METHODS We used two data sets that form part of the Collaborative Psychiatric Epidemiology Surveys - the National Latino and Asian American Study and the National Comorbidity Survey Replication. RESULTS We found an increased likelihood of cardiovascular events for those with a diagnosis of PTSD (odds ratio [OR] = 2.10, 95% CI = 1.32-3.33) when compared with those who had not experienced trauma. We did not find an increased risk for those who had experienced trauma without symptoms or with subclinical symptoms of PTSD. The higher likelihood of having a cardiovascular event in those with PTSD was significant for non-Latino whites (OR = 1.86, 95% CI = 1.08-3.11), Latinos (OR = 1.94, 95% CI = 1.04-3.62), and non-Latino blacks (OR = 3.73, 95% CI = 1.76-7.91), but not for Asian respondents. CONCLUSIONS The constellation of symptoms defining PTSD diagnosis reflect adverse reactions to traumatic events and indicate that complex responses to traumatic events may be a risk factor for CVD.
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Affiliation(s)
- Carmen Vidal
- From the Fundación Jiménez Díaz, Avda, Reyes Católicos, Madrid, Spain (Vidal, Polo); Disparities Research Unit, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston (Alvarez, Falgas-Bague, Wang, Alegría); Health Equity Research Lab, Cambridge Health Alliance and Harvard Medical School, Cambridge, Massachusetts (Lê Cook); and Department of Psychiatry, Harvard Medical School (Lê Cook), Departments of Medicine and Psychiatry, Harvard Medical School, Boston, Massachusetts (Alegría)
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Reyes-Ortiz CA, Ocampo-Chaparro JM, Campo-Arias A, Holmes H, Halphen J. Association Between History of Abuse and Falling in Older Adults. J Am Geriatr Soc 2018; 66:1603-1607. [DOI: 10.1111/jgs.15432] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2017] [Revised: 04/10/2018] [Accepted: 04/10/2018] [Indexed: 11/28/2022]
Affiliation(s)
- Carlos A. Reyes-Ortiz
- Division of Geriatric and Palliative Medicine, Department of Internal Medicine; University of Texas Health Science Center at Houston; Houston Texas
| | | | - Adalberto Campo-Arias
- Programa de Medicina, Facultad de Ciencias de la Salud; Universidad del Magdalena; Santa Marta Colombia
| | - Holly Holmes
- Division of Geriatric and Palliative Medicine, Department of Internal Medicine; University of Texas Health Science Center at Houston; Houston Texas
| | - John Halphen
- Division of Geriatric and Palliative Medicine, Department of Internal Medicine; University of Texas Health Science Center at Houston; Houston Texas
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Sexual Functioning After Childhood Abuse: The Influence of Post-Traumatic Stress Disorder and Trauma Exposure. J Sex Med 2018; 15:529-538. [DOI: 10.1016/j.jsxm.2018.02.016] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2017] [Revised: 02/09/2018] [Accepted: 02/17/2018] [Indexed: 11/19/2022]
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Abstract
OBJECTIVE Food insecurity is associated with toxic stress and adverse long-term physical and mental health outcomes. It can be experienced chronically and also triggered or exacerbated by natural and human-made hazards that destabilize the food system. The Baltimore Food System Resilience Advisory Report was created to strengthen the resilience of the city's food system and improve short- and long-term food security. Recognizing food insecurity as a form of trauma, the report was developed using the principles of trauma-informed social policy. In the present paper, we examine how the report applied trauma-informed principles to policy development, discuss the challenges and benefits of using a trauma-informed approach, and provide recommendations for others seeking to create trauma-informed food policy. DESIGN Report recommendations were developed based on: semi-structured interviews with food system stakeholders; input from community members at outreach events; a literature review; Geographic Information System mapping; and other analyses. The present paper explores findings from the stakeholder interviews. SETTING Baltimore, Maryland, USA. SUBJECTS Baltimore food system stakeholders stratified by two informant categories: organizations focused on promoting food access (n 13) and community leaders (n 12). RESULTS Stakeholder interviews informed the recommendations included in the report and supported the idea that chronic and acute food insecurity are experienced as trauma in the Baltimore community. CONCLUSIONS Applying a trauma-informed approach to the development of the Baltimore Food System Resilience Advisory Report contributed to policy recommendations that were community-informed and designed to lessen the traumatic impact of food insecurity.
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Boyraz G, Waits JB. Interpersonal Trauma and Physical Health Symptoms in College Students: Mediating Effects of Substance Use and Self-Blame. JOURNAL OF LOSS & TRAUMA 2018. [DOI: 10.1080/15325024.2017.1422849] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Güler Boyraz
- Psychology Department, Pace University, New York, New York, USA
| | - J. Brandon Waits
- Department of Psychology and Behavioral Sciences, Louisiana Tech University, Ruston, Louisiana, USA
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van de Kamp MM, Emck C, Cuijpers P, Beek PJ. A psychomotor diagnostic instrument for patients with post-traumatic stress disorder. BODY MOVEMENT AND DANCE IN PSYCHOTHERAPY 2018. [DOI: 10.1080/17432979.2017.1420692] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
| | - Claudia Emck
- Faculty of Behavioural and Movement Sciences, Vrije Universiteit, Amsterdam, The Netherlands
| | - Pim Cuijpers
- Faculty of Behavioural and Movement Sciences, Vrije Universiteit, Amsterdam, The Netherlands
| | - Peter J. Beek
- Faculty of Behavioural and Movement Sciences, Vrije Universiteit, Amsterdam, The Netherlands
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Sumner JA, Chen Q, Roberts AL, Winning A, Rimm EB, Gilsanz P, Glymour MM, Tworoger SS, Koenen KC, Kubzansky LD. Cross-Sectional and Longitudinal Associations of Chronic Posttraumatic Stress Disorder With Inflammatory and Endothelial Function Markers in Women. Biol Psychiatry 2017; 82:875-884. [PMID: 28778657 PMCID: PMC5683901 DOI: 10.1016/j.biopsych.2017.06.020] [Citation(s) in RCA: 44] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2017] [Revised: 05/24/2017] [Accepted: 06/20/2017] [Indexed: 12/31/2022]
Abstract
BACKGROUND Posttraumatic stress disorder (PTSD) may contribute to heightened cardiovascular disease risk by promoting a proinflammatory state and impaired endothelial function. Previous research has demonstrated associations of PTSD with inflammatory and endothelial function biomarkers, but most work has been cross-sectional and does not separate the effects of trauma exposure from those of PTSD. METHODS We investigated associations of trauma exposure and chronic PTSD with biomarkers of inflammation (C-reactive protein and tumor necrosis factor alpha receptor II) and endothelial function (intercellular adhesion molecule-1 and vascular cell adhesion molecule-1) in 524 middle-aged women in the Nurses' Health Study II. Using linear mixed models, we examined associations of trauma/PTSD status with biomarkers measured twice, 10 to 16 years apart, in cardiovascular disease-free women, considering either average levels over time (cross-sectional) or change in levels over time (longitudinal). Biomarker levels were log-transformed. Trauma/PTSD status (based on structured diagnostic interviews) was defined as no trauma at either blood draw (n = 175), trauma at blood draw 1 but no PTSD at either draw (n = 175), and PTSD that persisted beyond blood draw 1 (chronic PTSD; n = 174). The reference group was women without trauma. RESULTS In models adjusted for known potential confounders, women with chronic PTSD had higher average C-reactive protein (B = 0.27, p < .05), tumor necrosis factor alpha receptor II (B = 0.07, p < .01), and intercellular adhesion molecule-1 (B = 0.04, p < .05) levels. Women with trauma but without PTSD had higher average tumor necrosis factor alpha receptor II levels (B = 0.05, p < .05). In addition, women with chronic PTSD had a greater increase in vascular cell adhesion molecule-1 over time (B = 0.003, p < .05). CONCLUSIONS Increased inflammation and impaired endothelial function may be pathways by which chronic PTSD increases cardiovascular disease risk.
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Affiliation(s)
- Jennifer A. Sumner
- Center for Behavioral Cardiovascular Health, Columbia University Medical Center, New York, NY,Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA,Correspondence to: Jennifer Sumner, Center for Behavioral Cardiovascular Health, Columbia University Medical Center, 622 W. 168th St, PH 9-315, New York, NY 10032. Tel: 212-342-3133; Fax: 212-342-3431;
| | - Qixuan Chen
- Department of Biostatistics, Columbia University Mailman School of Public Health, New York, NY
| | - Andrea L. Roberts
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA
| | - Ashley Winning
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA
| | - Eric B. Rimm
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA,Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA,Channing Division of Network Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA
| | - Paola Gilsanz
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA
| | - M. Maria Glymour
- Department of Epidemiology and Biostatistics, University of California San Francisco School of Medicine, San Francisco, CA
| | - Shelley S. Tworoger
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA,Channing Division of Network Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA
| | - Karestan C. Koenen
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA,Psychiatric and Neurodevelopmental Genetics Unit and Department of Psychiatry, Massachusetts General Hospital, Boston, MA
| | - Laura D. Kubzansky
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA
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Kvalem IL, Bergh I, Sogg S, Mala T. Psychosocial characteristics associated with symptom perception 1 year after gastric bypass surgery—a prospective study. Surg Obes Relat Dis 2017; 13:1908-1913. [DOI: 10.1016/j.soard.2017.06.008] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2017] [Revised: 06/21/2017] [Accepted: 06/23/2017] [Indexed: 10/19/2022]
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Bugge I, Dyb G, Stensland SØ, Ekeberg Ø, Wentzel-Larsen T, Diseth TH. Physical Injury and Somatic Complaints: The Mediating Role of Posttraumatic Stress Symptoms in Young Survivors of a Terror Attack. J Trauma Stress 2017; 30:229-236. [PMID: 28556275 DOI: 10.1002/jts.22191] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2016] [Revised: 02/07/2017] [Accepted: 03/21/2017] [Indexed: 11/08/2022]
Abstract
Physically injured trauma survivors have particularly high risk for later somatic complaints and posttraumatic stress symptoms (PTSS). However, the potential mediating role of PTSS linking injury to later somatic complaints has been poorly investigated. In this study, survivors (N = 255) were interviewed longitudinally at 2 timepoints after the terror attack on Utøya Island, Norway, in 2011. Assessments included injury sustained during the attack, PTSS (after 4-5 months), somatic complaints (after 14-15 months), and background factors. Causal mediation analysis was conducted to evaluate the potential mediating role of PTSS in linking injury to somatic complaints comparing 2 groups of injured survivors with noninjured survivors. For the nonhospitalized injured versus the noninjured survivors, the mediated pathway was significant (average causal mediation effect; ACME = 0.09, p = .028, proportion = 55.8%). For the hospitalized versus the noninjured survivors, the mediated pathway was not significant (ACME = 0.04, p = .453, proportion = 11.6%). PTSS may play a significant mediating role in the development of somatic complaints among nonhospitalized injured trauma survivors. Intervening health professionals should be aware of this possible pathway to somatic complaints.
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Affiliation(s)
- Ingrid Bugge
- Section for Psychosomatics and CL-Child Psychiatry, Department of Clinical Neurosciences for Children, Division of Paediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway.,Department of Paediatrics, Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Grete Dyb
- Norwegian Centre for Violence and Traumatic Stress Studies, Oslo, Norway.,Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Synne Øien Stensland
- Norwegian Centre for Violence and Traumatic Stress Studies, Oslo, Norway.,Research and Communication Unit for Musculoskeletal Disorders, Oslo University Hospital, Oslo, Norway
| | - Øivind Ekeberg
- Department of Research and Development, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway.,Department of Behavioral Sciences in Medicine, Institute of Basic Medical Sciences, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Tore Wentzel-Larsen
- Norwegian Centre for Violence and Traumatic Stress Studies, Oslo, Norway.,Centre for Child and Adolescent Mental Health, Eastern and Southern Norway, Oslo, Norway
| | - Trond H Diseth
- Section for Psychosomatics and CL-Child Psychiatry, Department of Clinical Neurosciences for Children, Division of Paediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway.,Department of Paediatrics, Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
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Gilsanz P, Winning A, Koenen KC, Roberts AL, Sumner JA, Chen Q, Glymour MM, Rimm EB, Kubzansky LD. Post-traumatic stress disorder symptom duration and remission in relation to cardiovascular disease risk among a large cohort of women. Psychol Med 2017; 47:1370-1378. [PMID: 28052776 PMCID: PMC5429192 DOI: 10.1017/s0033291716003378] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
BACKGROUND Prior studies suggest that post-traumatic stress disorder (PTSD) is associated with elevated cardiovascular disease (CVD) risk, but effects of duration and remission of PTSD symptoms have rarely been evaluated. METHOD We examined the association of time-updated PTSD symptom severity, remission and duration with incident CVD risk (552 confirmed myocardial infarctions or strokes) over 20 years in 49 859 women in the Nurses' Health Study II. Among women who reported trauma on the Brief Trauma Questionnaire, PTSD symptoms, assessed by a screener, were classified by symptom severity and chronicity: (a) no symptoms, (b) 1-3 ongoing, (c) 4-5 ongoing, (d) 6-7 ongoing, (e) 1-3 remitted, (f) 4-7 remitted symptoms. Inverse probability weighting was used to estimate marginal structural logistic regression models, adjusting for time-varying and time-invariant confounders. RESULTS Compared with women with no trauma exposure, women with trauma/no PTSD [odds ratio (OR) 1.30, 95% confidence interval (CI) 1.03-1.65] and women with trauma/6-7 symptoms (OR 1.69, 95% CI 1.08-2.63) had elevated risk of CVD; women with remitted symptoms did not have elevated CVD risk. Among women exposed to trauma, every 5 additional years of PTSD symptomology was associated with 9% higher CVD incidence compared with women with trauma/no PTSD. CONCLUSIONS The findings suggest that alleviating PTSD symptoms shortly after onset may attenuate CVD risk.
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Affiliation(s)
- Paola Gilsanz
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA
| | - Ashley Winning
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA
| | - Karestan C. Koenen
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA
| | - Andrea L. Roberts
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA
| | - Jennifer A. Sumner
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA
- Center for Behavioral Cardiovascular Health, Columbia University Medical Center, New York, NY
| | - Qixuan Chen
- Department of Biostatistics, Mailman School of Public Health, Columbia University, New York, NY
| | - M. Maria Glymour
- Department of Epidemiology & Biostatistics, University of California San Francisco School of Medicine, San Francisco, CA
| | - Eric B. Rimm
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital
| | - Laura D. Kubzansky
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA
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Post-Traumatic Growth Following Politically Motivated Acts of Violence: 10 Years Post Injury. AUSTRALIAN JOURNAL OF REHABILITATION COUNSELLING 2017. [DOI: 10.1017/jrc.2017.6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
The study explored posttraumatic growth (PTG) and its relationship with the quality of life (QOL), posttraumatic stress, and resilience among survivors of terror attacks over 10 years post-injury. Participants were patients of Hadassah Medical Center, Israel, who were injured in terror attacks between 2000 and 2004 during the second Intifada. Variables of interest were obtained from a survey and patients' medical files. In total, 42 patients participated, 66% were men, and the average age was 41.4 years. Multivariate analysis was utilized to predict PTG from a variety of demographic variables including gender, ethnicity, relationship status, age, education, income, religiosity, and injury/disability type. Additional primary variables of study included current levels of QOL, posttraumatic stress, and resilience. Results revealed that married/partnered individuals had higher levels of PTG than divorced or single individuals. Findings suggest that social support following trauma is important for PTG and should be prioritized in recovery interventions with trauma survivors.
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Basu A, McLaughlin KA, Misra S, Koenen KC. Childhood Maltreatment and Health Impact: The Examples of Cardiovascular Disease and Type 2 Diabetes Mellitus in Adults. CLINICAL PSYCHOLOGY-SCIENCE AND PRACTICE 2017; 24:125-139. [PMID: 28867878 DOI: 10.1111/cpsp.12191] [Citation(s) in RCA: 66] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Child maltreatment is associated with increased risk for an array of mental and physical health problems. We reviewed studies examining associations of child maltreatment, assessed either alone or in combination with other adversities, with cardiovascular disease (CVD) and Type 2 Diabetes. PubMed was searched for relevant studies until December, 2015. Forty publications met inclusion criteria. Consistent positive associations were noted across a range of childhood adversities. Child maltreatment was associated with CVD (myocardial infarction, stroke, ischemic heart disease, coronary heart disease) in 91.7% of studies, with diabetes in 88.2% of studies, and with blood pressure/hypertension in 61.5% of studies. Inclusion of mental disorders tended to attenuate associations. Sex-related differences were under-examined. Implications for future research and intervention efforts are discussed.
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Affiliation(s)
- Archana Basu
- Harvard T. H. Chan School of Public Health, Massachusetts General Hospital
| | | | | | - Karestan C Koenen
- Harvard T. H. Chan School of Public Health, Massachusetts General Hospital
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Quested R, Sommerville S, Lutz M. Outcomes following non-life-threatening orthopaedic trauma: Why are they considered to be so poor? TRAUMA-ENGLAND 2017. [DOI: 10.1177/1460408616674233] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The purpose of this review article is to assess the current literature on the outcomes of simple orthopaedic trauma. Simple trauma is defined as the fracture or injury of one limb due to an acute event. Fractures are the most common cause of hospitalized trauma in Australia and associated with multiple social, psychological and physical consequences for patients. The literature to date suggests that there are multiple factors leading to relatively poor outcomes following simple trauma, modifiable and non-modifiable. The most oft cited are older age, lower educational status, being injured at work, injury severity score, pre-existing disease, workers compensation, litigation and pain at initial assessment. Additional psychological risk factors quoted attribute to the injury to an external source and the use of passive coping strategies. This review aims to summarise the relevant literature relating to these risk factors and give direction to improving outcomes and future research into this important area.
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Affiliation(s)
- Rachele Quested
- Orthopaedic Department, Ipswich General Hospital, School of Medicine, University of Queensland, Queensland, Australia
| | - Scott Sommerville
- The Wesley Hospital, School of Medicine, University of Queensland, Queensland, Australia
| | - Michael Lutz
- St Andrews War Memorial Hospital, School of Medicine, University of Queensland, Queensland, Australia
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Wang TY, Wei HT, Liou YJ, Su TP, Bai YM, Tsai SJ, Yang AC, Chen TJ, Tsai CF, Chen MH. Risk for developing dementia among patients with posttraumatic stress disorder: A nationwide longitudinal study. J Affect Disord 2016; 205:306-310. [PMID: 27552595 DOI: 10.1016/j.jad.2016.08.013] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2016] [Revised: 07/06/2016] [Accepted: 08/14/2016] [Indexed: 10/21/2022]
Abstract
OBJECTIVES Previous studies suggested a relationship between posttraumatic stress disorder (PTSD) in the specific population (i.e., war survivors and veterans) and subsequent dementia risk. However, whether patients with PTSD in the general population were at an increased risk for developing dementia in later life remained unclear. METHODS The Cox regression analysis was performed using data from the Taiwan National Health Insurance Research Database. The study sample comprised 1750 patients diagnosed with PTSD between 2001 and 2009 and 7000 age-/sex-matched individuals without PTSD. Those who developed dementia during follow-up to the end of 2011 were identified. RESULTS After adjusting for demographic data and medical and psychiatric comorbidities, PTSD was an independent risk factor for the risk for subsequent dementia (hazard ratio [HR]=4.37; 95% confidence interval [CI]: 2.53-7.55). There was a dose-dependent relationship between PTSD severity indicated by the frequency of psychiatric clinics visiting of PTSD (times per year) and the risk of subsequent dementia (<5: HR: 2.81, 95% CI: 1.50-5.29; 5-10: 6.90, 95% CI: 3.09-15.40;>10: HR: 18.13, 95% CI: 9.13-36.00). Furthermore, patients with depressive disorder and medical comorbidities, such as cerebrovascular diseases, diabetes mellitus, and head injuries, exhibited a higher risk for developing dementia. DISCUSSIONS Our study suggested a significant dose-dependent association between PTSD and its severity and an increased risk of developing dementia later in life. The importance of mental care for trauma victims would increase in the coming century, and our findings broadened another era for the end result of a widely prevalent psychiatric disorder.
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Affiliation(s)
- Tsung-Yang Wang
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan; Department of Psychiatry, College of Medicine, National Yang-Ming University, Taipei, Taiwan; Department of Forensic and Neurodevelopmental Sciences, London, United Kingdom
| | - Han-Ting Wei
- Department of Psychiatry, College of Medicine, National Yang-Ming University, Taipei, Taiwan; Division of Psychiatry, Kunming Branch, Taipei City Hospital, Taipei, Taiwan
| | - Ying-Jay Liou
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan; Department of Psychiatry, College of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Tung-Ping Su
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan; Department of Psychiatry, College of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Ya-Mei Bai
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan; Department of Psychiatry, College of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Shih-Jen Tsai
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan; Department of Psychiatry, College of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Albert C Yang
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan; Department of Psychiatry, College of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Tzeng-Ji Chen
- Department of Family Medicine, Taipei Veterans General Hospital, Taipei, Taiwan; Institute of Hospital and Health Care Administration, National Yang-Ming University, Taipei, Taiwan
| | - Chia-Fen Tsai
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan; Department of Psychiatry, College of Medicine, National Yang-Ming University, Taipei, Taiwan.
| | - Mu-Hong Chen
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan; Department of Psychiatry, College of Medicine, National Yang-Ming University, Taipei, Taiwan.
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Atwoli L, Platt JM, Basu A, Williams DR, Stein DJ, Koenen KC. Associations between lifetime potentially traumatic events and chronic physical conditions in the South African Stress and Health Survey: a cross-sectional study. BMC Psychiatry 2016; 16:214. [PMID: 27389090 PMCID: PMC4936266 DOI: 10.1186/s12888-016-0929-z] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2015] [Accepted: 06/20/2016] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND This study examined the association between the type, and cumulative number of lifetime potentially traumatic events (PTEs), and chronic physical conditions, in a South African sample. PTE exposures have been associated with an increased risk for a wide range of chronic physical conditions, but it is unclear whether psychiatric disorders mediate this association. Given the established differences in trauma occurrence, and the epidemiology of posttraumatic stress disorder (PTSD) in South Africa relative to other countries, examining associations between PTEs and chronic physical conditions, particularly while accounting for psychiatric comorbidity is important. METHODS Data were drawn from the South African Stress and Health Study, a cross-sectional population-representative study of psychological and physical health of South African adults. Twenty-seven PTEs, based on the World Health Organization Composite International Diagnostic Interview Version 3.0, DSM-IV PTSD module were grouped into seven PTE types (war events, physical violence, sexual violence, accidents, unexpected death of a loved one, network events, and witnessing PTEs). Five clusters of physical conditions (cardiovascular, arthritis, respiratory, chronic pain, and other health conditions) were examined. Logistic regressions assessed the odds of reporting a physical condition in relation to type and cumulative number of PTEs. Cochran-Armitage test for trend was used to examine dose-response effect of cumulative PTEs on physical conditions. RESULTS After adjusting for sociodemographic variables and psychiatric disorders, respondents with any PTE had increased odds of all assessed physical conditions, ranging between 1.48 (95 % CI: 1.06-2.07) for arthritis and 2.07 (95 % CI: 1.57-2.73) for respiratory conditions, compared to those without PTE exposure. Sexual violence, physical violence, unexpected death of a loved one, and network PTEs significantly increased the odds of all or nearly all the physical conditions assessed. There was a dose-response relationship between number of PTEs and increased odds of all physical conditions. CONCLUSIONS Results from this study, the first in an African general population, are consistent with other population-based studies; PTEs confer a broad-spectrum risk for chronic physical conditions, independent of psychiatric disorders. These risks increase with each cumulative PTE exposure. Clinically, comprehensive evaluations for risk of mental and physical health morbidities should be considered among PTE survivors.
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Affiliation(s)
- Lukoye Atwoli
- Department of Mental Health, Moi University School of Medicine, PO Box 1493, Eldoret, 30100, Kenya. .,Department of Psychiatry and Mental Health, MRC Unit on Anxiety and Stress Disorders, University of Cape Town, Cape Town, South Africa.
| | - Jonathan M. Platt
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY USA
| | - Archana Basu
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA USA
| | - David R. Williams
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA USA
| | - Dan J. Stein
- Department of Psychiatry and Mental Health, MRC Unit on Anxiety and Stress Disorders, University of Cape Town, Cape Town, South Africa
| | - Karestan C. Koenen
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA USA ,Psychiatric and Neurodevelopmental Genetics Unit, Center for Human Genetic Research, Massachusetts General Hospital, Boston, MA USA
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Vaughan AD, Moran CB, Pearce LDR, Hearty L. The influence of organizational support on the life course of trauma in emergency responders from British Columbia. JOURNAL OF WORKPLACE BEHAVIORAL HEALTH 2016. [DOI: 10.1080/15555240.2016.1195693] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Monti E, Kidd DC, Carroll LM, Castano E. What's in a singer's voice: The effect of attachment, emotions and trauma. LOGOP PHONIATR VOCO 2016; 42:62-72. [PMID: 27075743 DOI: 10.3109/14015439.2016.1166394] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Research shows that negative experiences in childhood have a long-lasting impact on one's psychological outcomes and one's physiology. The voice is a crucial means of expression, and its complex physiology is believed to be reflective of emotional and mental states. Parenting practices (particularly those contributing to insecure attachment) and traumatic experiences in childhood may thus also influence vocal characteristics. Except for literature on psychogenic voice disorders, the relationship between such experiences and the 'normal' voice is generally unexplored; we propose that a potential relationship is most likely to emerge in singers, for whom the voice is a more central part of their sense of self. In this paper, we test the hypothesis that vocal characteristics relate to attachment and trauma history. Study 1: 25 singers (age 18-35) completed an attachment history questionnaire (ECR-R) and the Singing Voice Handicap Index. Voice range profile and perturbation measures were recorded and analyzed for voice quality assessment. Study 2: 26 singers (age 19-33) completed the attachment history questionnaire, the Childhood Trauma Questionnaire, and the State and Trait Anxiety Inventory. They were also administered the Test of Self-Conscious Affect to assess shame and guilt proneness. Voice range profile, perturbation, and spectrogram measures were recorded and analyzed. The results indicated that anxious attachment, shame, and emotional neglect can predict vocal acoustic measures of intensity and, to some extent, perturbation. This suggests the need to address attachment, shame, and trauma history patterns in the aspiring performer.
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Affiliation(s)
- Elisa Monti
- a Department of Psychology, New School for Social Research , New York , USA
| | - David C Kidd
- a Department of Psychology, New School for Social Research , New York , USA
| | - Linda M Carroll
- b Graduate School of Speech-Language Pathology, Yeshiva University , New York , USA
| | - Emanuele Castano
- a Department of Psychology, New School for Social Research , New York , USA
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High Prevalence of Post-Traumatic Stress Symptoms in Relation to Social Factors in Affected Population One Year after the Fukushima Nuclear Disaster. PLoS One 2016; 11:e0151807. [PMID: 27002324 PMCID: PMC4803346 DOI: 10.1371/journal.pone.0151807] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2015] [Accepted: 03/04/2016] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE This study investigated post-traumatic stress symptoms in relation to the population affected by the Fukushima Nuclear Disaster, one year after the disaster. Additionally, we investigated social factors, such as forced displacement, which we hypothesize contributed to the high prevalence of post-traumatic stress. Finally, we report of written narratives that were collected from the impacted population. DESIGN AND SETTINGS Using the Impact of Event Scale-Revised (IES-R), questionnaires were sent to 2,011 households of those displaced from Fukushima prefecture living temporarily in Saitama prefecture. Of the 490 replies; 350 met the criteria for inclusion in the study. Multiple logistic regression analysis was performed to examine several characteristics and variables of social factors as predictors of probable post-traumatic stress disorder, PTSD. RESULTS The mean score of IES-R was 36.15±21.55, with 59.4% having scores of 30 or higher, thus indicating a probable PTSD. No significant differences in percentages of high-risk subjects were found among sex, age, evacuation area, housing damages, tsunami affected, family split-up, and acquaintance support. By the result of multiple logistic regression analysis, the significant predictors of probable PTSD were chronic physical diseases (OR = 1.97), chronic mental diseases (OR = 6.25), worries about livelihood (OR = 2.27), lost jobs (OR = 1.71), lost social ties (OR = 2.27), and concerns about compensation (OR = 3.74). CONCLUSION Although there are limitations in assuming a diagnosis of PTSD based on self-report IES-R, our findings indicate that there was a high-risk of PTSD strongly related to the nuclear disaster and its consequent evacuation and displacement. Therefore, recovery efforts must focus not only on medical and psychological treatment alone, but also on social and economic issues related to the displacement, as well.
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Levine CS, Basu D, Chen E. Just World Beliefs Are Associated With Lower Levels of Metabolic Risk and Inflammation and Better Sleep After an Unfair Event. J Pers 2016; 85:232-243. [PMID: 26691417 DOI: 10.1111/jopy.12236] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
This study's goal was to conduct a preliminary test of the theory that just world beliefs can buffer against negative physiological outcomes after people experience certain types of negative life events by testing associations between just world beliefs and physiological outcomes among people with different life event histories. In a sample of 247 adults (Mage = 46.01; 24.31% men; 60.78% White), this research investigated the relationship between just world beliefs and metabolic symptoms, inflammation, and sleep among people who had recently experienced an unfair event, another type of negative event, or no negative event. Stronger just world beliefs correlated with lower metabolic risk, lower inflammation, and better sleep among people who had recently experienced an unfair event, but not among those in the other two event groups. These findings suggest that people's beliefs about the world may interact with their life experiences in ways that have implications for health-relevant outcomes.
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50
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Sumner JA, Kubzansky LD, Elkind MSV, Roberts AL, Agnew-Blais J, Chen Q, Cerdá M, Rexrode KM, Rich-Edwards JW, Spiegelman D, Suglia SF, Rimm EB, Koenen KC. Trauma Exposure and Posttraumatic Stress Disorder Symptoms Predict Onset of Cardiovascular Events in Women. Circulation 2015; 132:251-9. [PMID: 26124186 PMCID: PMC4519406 DOI: 10.1161/circulationaha.114.014492] [Citation(s) in RCA: 190] [Impact Index Per Article: 21.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2014] [Accepted: 05/08/2015] [Indexed: 11/16/2022]
Abstract
BACKGROUND Psychological stress is a proposed risk factor for cardiovascular disease (CVD), and posttraumatic stress disorder (PTSD), the sentinel stress-related mental disorder, occurs twice as frequently in women as men. However, whether PTSD contributes to CVD risk in women is not established. METHODS AND RESULTS We examined trauma exposure and PTSD symptoms in relation to incident CVD over a 20-year period in 49 978 women in the Nurses' Health Study II. Proportional hazards models estimated hazard ratios and 95% confidence intervals for CVD events confirmed by additional information or medical record review (n=548, including myocardial infarction [n=277] and stroke [n=271]). Trauma exposure and PTSD symptoms were assessed by using the Brief Trauma Questionnaire and a PTSD screen. In comparison with no trauma exposure, endorsing ≥4 PTSD symptoms was associated with increased CVD risk after adjusting for age, family history, and childhood factors (hazard ratio,1.60; 95% confidence interval, 1.20-2.13). Being trauma-exposed and endorsing no PTSD symptoms was associated with elevated CVD risk (hazard ratio, 1.45; 95% confidence interval, 1.15-1.83), although being trauma-exposed and endorsing 1 to 3 PTSD symptoms was not. After adjusting for adult health behaviors and medical risk factors, this pattern of findings was maintained. Health behaviors and medical risk factors accounted for 14% of the trauma/no symptoms-CVD association and 47% of the trauma/4+ symptoms-CVD association. CONCLUSION Trauma exposure and elevated PTSD symptoms may increase the risk of CVD in this population of women. These findings suggest that screening for CVD risk and reducing health risk behaviors in trauma-exposed women may be promising avenues for prevention and intervention.
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Affiliation(s)
- Jennifer A Sumner
- From Department of Epidemiology, Columbia University Mailman School of Public Health, New York (J.A.S., M.S.V.E., M.C., S.F.S., K.C.K.); Department of Social and Behavioral Sciences, Harvard School of Public Health, Boston, MA (L.D.K., A.L.R., J.A.-B., K.C.K.); Department of Neurology, Columbia College of Physicians and Surgeons, New York (M.S.V.E.); Department of Biostatistics, Columbia University Mailman School of Public Health, New York (Q.C.); Division of Preventive Medicine, Brigham and Women's Hospital, Boston, MA (K.M.R.); Department of Epidemiology, Harvard School of Public Health, Boston, MA (J.W.R.-E., D.S., E.B.R., K.C.K.); The Connors Center for Women's Health and Gender Biology, Brigham and Women's Hospital, Boston, MA (J.W.R.-E.); Department of Biostatistics, Harvard School of Public Health, Boston, MA (D.S.); Department of Nutrition, Harvard School of Public Health, Boston, MA (E.B.R.); and Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA (E.B.R.).
| | - Laura D Kubzansky
- From Department of Epidemiology, Columbia University Mailman School of Public Health, New York (J.A.S., M.S.V.E., M.C., S.F.S., K.C.K.); Department of Social and Behavioral Sciences, Harvard School of Public Health, Boston, MA (L.D.K., A.L.R., J.A.-B., K.C.K.); Department of Neurology, Columbia College of Physicians and Surgeons, New York (M.S.V.E.); Department of Biostatistics, Columbia University Mailman School of Public Health, New York (Q.C.); Division of Preventive Medicine, Brigham and Women's Hospital, Boston, MA (K.M.R.); Department of Epidemiology, Harvard School of Public Health, Boston, MA (J.W.R.-E., D.S., E.B.R., K.C.K.); The Connors Center for Women's Health and Gender Biology, Brigham and Women's Hospital, Boston, MA (J.W.R.-E.); Department of Biostatistics, Harvard School of Public Health, Boston, MA (D.S.); Department of Nutrition, Harvard School of Public Health, Boston, MA (E.B.R.); and Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA (E.B.R.)
| | - Mitchell S V Elkind
- From Department of Epidemiology, Columbia University Mailman School of Public Health, New York (J.A.S., M.S.V.E., M.C., S.F.S., K.C.K.); Department of Social and Behavioral Sciences, Harvard School of Public Health, Boston, MA (L.D.K., A.L.R., J.A.-B., K.C.K.); Department of Neurology, Columbia College of Physicians and Surgeons, New York (M.S.V.E.); Department of Biostatistics, Columbia University Mailman School of Public Health, New York (Q.C.); Division of Preventive Medicine, Brigham and Women's Hospital, Boston, MA (K.M.R.); Department of Epidemiology, Harvard School of Public Health, Boston, MA (J.W.R.-E., D.S., E.B.R., K.C.K.); The Connors Center for Women's Health and Gender Biology, Brigham and Women's Hospital, Boston, MA (J.W.R.-E.); Department of Biostatistics, Harvard School of Public Health, Boston, MA (D.S.); Department of Nutrition, Harvard School of Public Health, Boston, MA (E.B.R.); and Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA (E.B.R.)
| | - Andrea L Roberts
- From Department of Epidemiology, Columbia University Mailman School of Public Health, New York (J.A.S., M.S.V.E., M.C., S.F.S., K.C.K.); Department of Social and Behavioral Sciences, Harvard School of Public Health, Boston, MA (L.D.K., A.L.R., J.A.-B., K.C.K.); Department of Neurology, Columbia College of Physicians and Surgeons, New York (M.S.V.E.); Department of Biostatistics, Columbia University Mailman School of Public Health, New York (Q.C.); Division of Preventive Medicine, Brigham and Women's Hospital, Boston, MA (K.M.R.); Department of Epidemiology, Harvard School of Public Health, Boston, MA (J.W.R.-E., D.S., E.B.R., K.C.K.); The Connors Center for Women's Health and Gender Biology, Brigham and Women's Hospital, Boston, MA (J.W.R.-E.); Department of Biostatistics, Harvard School of Public Health, Boston, MA (D.S.); Department of Nutrition, Harvard School of Public Health, Boston, MA (E.B.R.); and Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA (E.B.R.)
| | - Jessica Agnew-Blais
- From Department of Epidemiology, Columbia University Mailman School of Public Health, New York (J.A.S., M.S.V.E., M.C., S.F.S., K.C.K.); Department of Social and Behavioral Sciences, Harvard School of Public Health, Boston, MA (L.D.K., A.L.R., J.A.-B., K.C.K.); Department of Neurology, Columbia College of Physicians and Surgeons, New York (M.S.V.E.); Department of Biostatistics, Columbia University Mailman School of Public Health, New York (Q.C.); Division of Preventive Medicine, Brigham and Women's Hospital, Boston, MA (K.M.R.); Department of Epidemiology, Harvard School of Public Health, Boston, MA (J.W.R.-E., D.S., E.B.R., K.C.K.); The Connors Center for Women's Health and Gender Biology, Brigham and Women's Hospital, Boston, MA (J.W.R.-E.); Department of Biostatistics, Harvard School of Public Health, Boston, MA (D.S.); Department of Nutrition, Harvard School of Public Health, Boston, MA (E.B.R.); and Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA (E.B.R.)
| | - Qixuan Chen
- From Department of Epidemiology, Columbia University Mailman School of Public Health, New York (J.A.S., M.S.V.E., M.C., S.F.S., K.C.K.); Department of Social and Behavioral Sciences, Harvard School of Public Health, Boston, MA (L.D.K., A.L.R., J.A.-B., K.C.K.); Department of Neurology, Columbia College of Physicians and Surgeons, New York (M.S.V.E.); Department of Biostatistics, Columbia University Mailman School of Public Health, New York (Q.C.); Division of Preventive Medicine, Brigham and Women's Hospital, Boston, MA (K.M.R.); Department of Epidemiology, Harvard School of Public Health, Boston, MA (J.W.R.-E., D.S., E.B.R., K.C.K.); The Connors Center for Women's Health and Gender Biology, Brigham and Women's Hospital, Boston, MA (J.W.R.-E.); Department of Biostatistics, Harvard School of Public Health, Boston, MA (D.S.); Department of Nutrition, Harvard School of Public Health, Boston, MA (E.B.R.); and Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA (E.B.R.)
| | - Magdalena Cerdá
- From Department of Epidemiology, Columbia University Mailman School of Public Health, New York (J.A.S., M.S.V.E., M.C., S.F.S., K.C.K.); Department of Social and Behavioral Sciences, Harvard School of Public Health, Boston, MA (L.D.K., A.L.R., J.A.-B., K.C.K.); Department of Neurology, Columbia College of Physicians and Surgeons, New York (M.S.V.E.); Department of Biostatistics, Columbia University Mailman School of Public Health, New York (Q.C.); Division of Preventive Medicine, Brigham and Women's Hospital, Boston, MA (K.M.R.); Department of Epidemiology, Harvard School of Public Health, Boston, MA (J.W.R.-E., D.S., E.B.R., K.C.K.); The Connors Center for Women's Health and Gender Biology, Brigham and Women's Hospital, Boston, MA (J.W.R.-E.); Department of Biostatistics, Harvard School of Public Health, Boston, MA (D.S.); Department of Nutrition, Harvard School of Public Health, Boston, MA (E.B.R.); and Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA (E.B.R.)
| | - Kathryn M Rexrode
- From Department of Epidemiology, Columbia University Mailman School of Public Health, New York (J.A.S., M.S.V.E., M.C., S.F.S., K.C.K.); Department of Social and Behavioral Sciences, Harvard School of Public Health, Boston, MA (L.D.K., A.L.R., J.A.-B., K.C.K.); Department of Neurology, Columbia College of Physicians and Surgeons, New York (M.S.V.E.); Department of Biostatistics, Columbia University Mailman School of Public Health, New York (Q.C.); Division of Preventive Medicine, Brigham and Women's Hospital, Boston, MA (K.M.R.); Department of Epidemiology, Harvard School of Public Health, Boston, MA (J.W.R.-E., D.S., E.B.R., K.C.K.); The Connors Center for Women's Health and Gender Biology, Brigham and Women's Hospital, Boston, MA (J.W.R.-E.); Department of Biostatistics, Harvard School of Public Health, Boston, MA (D.S.); Department of Nutrition, Harvard School of Public Health, Boston, MA (E.B.R.); and Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA (E.B.R.)
| | - Janet W Rich-Edwards
- From Department of Epidemiology, Columbia University Mailman School of Public Health, New York (J.A.S., M.S.V.E., M.C., S.F.S., K.C.K.); Department of Social and Behavioral Sciences, Harvard School of Public Health, Boston, MA (L.D.K., A.L.R., J.A.-B., K.C.K.); Department of Neurology, Columbia College of Physicians and Surgeons, New York (M.S.V.E.); Department of Biostatistics, Columbia University Mailman School of Public Health, New York (Q.C.); Division of Preventive Medicine, Brigham and Women's Hospital, Boston, MA (K.M.R.); Department of Epidemiology, Harvard School of Public Health, Boston, MA (J.W.R.-E., D.S., E.B.R., K.C.K.); The Connors Center for Women's Health and Gender Biology, Brigham and Women's Hospital, Boston, MA (J.W.R.-E.); Department of Biostatistics, Harvard School of Public Health, Boston, MA (D.S.); Department of Nutrition, Harvard School of Public Health, Boston, MA (E.B.R.); and Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA (E.B.R.)
| | - Donna Spiegelman
- From Department of Epidemiology, Columbia University Mailman School of Public Health, New York (J.A.S., M.S.V.E., M.C., S.F.S., K.C.K.); Department of Social and Behavioral Sciences, Harvard School of Public Health, Boston, MA (L.D.K., A.L.R., J.A.-B., K.C.K.); Department of Neurology, Columbia College of Physicians and Surgeons, New York (M.S.V.E.); Department of Biostatistics, Columbia University Mailman School of Public Health, New York (Q.C.); Division of Preventive Medicine, Brigham and Women's Hospital, Boston, MA (K.M.R.); Department of Epidemiology, Harvard School of Public Health, Boston, MA (J.W.R.-E., D.S., E.B.R., K.C.K.); The Connors Center for Women's Health and Gender Biology, Brigham and Women's Hospital, Boston, MA (J.W.R.-E.); Department of Biostatistics, Harvard School of Public Health, Boston, MA (D.S.); Department of Nutrition, Harvard School of Public Health, Boston, MA (E.B.R.); and Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA (E.B.R.)
| | - Shakira F Suglia
- From Department of Epidemiology, Columbia University Mailman School of Public Health, New York (J.A.S., M.S.V.E., M.C., S.F.S., K.C.K.); Department of Social and Behavioral Sciences, Harvard School of Public Health, Boston, MA (L.D.K., A.L.R., J.A.-B., K.C.K.); Department of Neurology, Columbia College of Physicians and Surgeons, New York (M.S.V.E.); Department of Biostatistics, Columbia University Mailman School of Public Health, New York (Q.C.); Division of Preventive Medicine, Brigham and Women's Hospital, Boston, MA (K.M.R.); Department of Epidemiology, Harvard School of Public Health, Boston, MA (J.W.R.-E., D.S., E.B.R., K.C.K.); The Connors Center for Women's Health and Gender Biology, Brigham and Women's Hospital, Boston, MA (J.W.R.-E.); Department of Biostatistics, Harvard School of Public Health, Boston, MA (D.S.); Department of Nutrition, Harvard School of Public Health, Boston, MA (E.B.R.); and Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA (E.B.R.)
| | - Eric B Rimm
- From Department of Epidemiology, Columbia University Mailman School of Public Health, New York (J.A.S., M.S.V.E., M.C., S.F.S., K.C.K.); Department of Social and Behavioral Sciences, Harvard School of Public Health, Boston, MA (L.D.K., A.L.R., J.A.-B., K.C.K.); Department of Neurology, Columbia College of Physicians and Surgeons, New York (M.S.V.E.); Department of Biostatistics, Columbia University Mailman School of Public Health, New York (Q.C.); Division of Preventive Medicine, Brigham and Women's Hospital, Boston, MA (K.M.R.); Department of Epidemiology, Harvard School of Public Health, Boston, MA (J.W.R.-E., D.S., E.B.R., K.C.K.); The Connors Center for Women's Health and Gender Biology, Brigham and Women's Hospital, Boston, MA (J.W.R.-E.); Department of Biostatistics, Harvard School of Public Health, Boston, MA (D.S.); Department of Nutrition, Harvard School of Public Health, Boston, MA (E.B.R.); and Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA (E.B.R.)
| | - Karestan C Koenen
- From Department of Epidemiology, Columbia University Mailman School of Public Health, New York (J.A.S., M.S.V.E., M.C., S.F.S., K.C.K.); Department of Social and Behavioral Sciences, Harvard School of Public Health, Boston, MA (L.D.K., A.L.R., J.A.-B., K.C.K.); Department of Neurology, Columbia College of Physicians and Surgeons, New York (M.S.V.E.); Department of Biostatistics, Columbia University Mailman School of Public Health, New York (Q.C.); Division of Preventive Medicine, Brigham and Women's Hospital, Boston, MA (K.M.R.); Department of Epidemiology, Harvard School of Public Health, Boston, MA (J.W.R.-E., D.S., E.B.R., K.C.K.); The Connors Center for Women's Health and Gender Biology, Brigham and Women's Hospital, Boston, MA (J.W.R.-E.); Department of Biostatistics, Harvard School of Public Health, Boston, MA (D.S.); Department of Nutrition, Harvard School of Public Health, Boston, MA (E.B.R.); and Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA (E.B.R.)
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