Post-traumatic growth among 5195 adolescents at 8.5 years after exposure to the Wenchuan earthquake: Roles of post-traumatic stress disorder and self-esteem

Interaction between posttraumatic stress symptoms and posttraumatic growth among adolescents who experience an earthquake: A repeated longitudinal study

For adolescents who experience an earthquake, posttraumatic stress symptoms (PTSSs) and posttraumatic growth (PTG) often co-occur. However, no study has yet examined how the interaction between them changes from the short term to the long term after an earthquake. This study conducted six surveys among local adolescents across three waves after the Wenchuan earthquake, and a directed network of PTSS and PTG co-occurrence was constructed for each wave. It was found that the bridge nodes between PTSSs and PTG were different for each wave. The connection between PTSSs and PTG became loose over time. The incubation effect of PTSSs on PTG was sustained until the middle term but was not observed in the long term. The suppression effect of PTSSs on PTG was only observed in the short term. PTG not only alleviated PTSSs but also exacerbated PTSSs. Finally, the effect of PTSSs on PTG was much stronger than that of PTG on PTSSs. This study suggests that efforts should be made to alleviate specific PTSSs or facilitate specific PTG elements among adolescents for different terms after an earthquake, and PTG is more likely to be an outcome of trauma rather than a strategy for coping with trauma.

The neural circuits and molecular mechanisms underlying fear dysregulation in posttraumatic stress disorder

Post-traumatic stress disorder (PTSD) is a stress-associated complex and debilitating psychiatric disorder due to an imbalance of neurotransmitters in response to traumatic events or fear. PTSD is characterized by re-experiencing, avoidance behavior, hyperarousal, negative emotions, insomnia, personality changes, and memory problems following exposure to severe trauma. However, the biological mechanisms and symptomatology underlying this disorder are still largely unknown or poorly understood. Considerable evidence shows that PTSD results from a dysfunction in highly conserved brain systems involved in regulating stress, anxiety, fear, and reward circuitry. This review provides a contemporary update about PTSD, including new data from the clinical and preclinical literature on stress, PTSD, and fear memory consolidation and extinction processes. First, we present an overview of well-established laboratory models of PTSD and discuss their clinical translational value for finding various treatments for PTSD. We then highlight the research progress on the neural circuits of fear and extinction-related behavior, including the prefrontal cortex, hippocampus, and amygdala. We further describe different molecular mechanisms, including GABAergic, glutamatergic, cholinergic, and neurotropic signaling, responsible for the structural and functional changes during fear acquisition and fear extinction processes in PTSD.

Post-Traumatic Stress Disorder Is Associated with Elevated Plasma Cholesterol in Female TT Homozygotes of LDLR rs5925

To explore the mechanism of inconsistent relationships between plasma lipid profiles and post-traumatic stress disorder (PTSD) reported before, we hypothesized that interplays might exist between PTSD and a variation of rs5925 at low-density lipoprotein receptor (LDLR) gene on plasma lipid profiles. To test our hypothesis, we analyzed the plasma lipid profiles of 709 high school pupils with various genotypes of LDLR rs5925 and with or without PTSD. The results demonstrated that PTSD prevalence in the C allele carriers was higher than that in the TT homozygotes regardless of gender. The C allele carriers had higher levels of total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), ratios of TC to high-density lipoprotein cholesterol (TC/HDL-C) and LDL-C/HDL-C than the TT homozygotes in the male controls, and only higher TC in the female controls, but no differences in the male or female PTSD subjects. PTSD increased TC in the female TT homozygotes but not in the female C allele carriers. PTSD increased TC/HDL-C in the male TT homozygotes but not in the C allele carriers. These results suggest interactions between PTSD and LDLR rs5925 on plasma lipid profiles, which may be among the explanations for previously reported inconsistent relationships between LDLR rs5925 or PTSD and plasma lipid profiles, and facilitate the development of precision medicine interferences in hypercholesterolemia in individuals with different genetic backgrounds and psychiatric status. Psychiatric care or drug supplement may particularly be needed by female hypercholesterolemic subjects with the TT genotype of LDLR rs5925 in Chinese adolescents.

The moderating role of resilience in the relationship between state and trait anxiety and post-traumatic growth of medical freshmen

BACKGROUND

Psychological distress such as anxiety of medical students especially during the first-year has been widely acknowledged. However, many students could exhibit post-traumatic growth when experiencing anxiety. Previous study demonstrated that anxiety might have impacts on post-traumatic growth, but how anxiety affects post-traumatic growth is still undefined. This study sought to examine whether resilience has a moderating role between state and trait anxiety and post-traumatic growth when medical freshmen are experiencing stressful events.

METHODS

A total of 295 medical freshmen were administered the Post Traumatic Growth Inventory, the State-Trait Anxiety Inventory and the Connor-Davidson Resilience Scale.

RESULTS

Post-traumatic growth was negatively correlated with state anxiety and trait anxiety, with a correlation coefficient of -0.474 and -0.462 (p < 0.01), and positively correlated with resilience, with a correlation coefficient of 0.635 (p < 0.01). Resilience acted as a moderator for the indirect effect of state and trait anxiety on post-traumatic growth.

CONCLUSIONS

These findings demonstrated resilience could be of extreme importance for developing post-traumatic growth, and therapeutic interventions tailored to the medical freshmen to promote their resilience to adapt to life in college.

Prospective examination of adolescent emotional intelligence and post-traumatic growth during and after COVID-19 lockdown

OBJECTIVES

While there have been some studies examining the post-traumatic growth (PTG) responses to the COVID-19 pandemic, few have been longitudinal studies exploring the changes over time or examining the underlying psychological PTG mechanisms. This study examined whether baseline perceived emotional intelligence (EI) predicted PTG through self-esteem and emotional regulation (ER) in a five-month follow-up study conducted on Chinese adolescents during the COVID-19 pandemic.

METHODS

Validated measures were completed by 2090 participants, which assessed both the perceived EI and the PTG 1 month after a nationwide lockdown in China, with 1609 of these participating in the follow-up five months later. Structural equation models (SEM) were then used to explore the paths between the variables.

RESULTS

As hypothesized, the follow-up survey found that the baseline perceived EI predicted PTG, ER, and self-esteem outcomes. The SEM analyses also revealed that self-esteem and ER significantly mediated the association between EI and PTG.

LIMITATIONS

Studies of three or more waves may be more suitable for longitudinal mediation analyses. Self-assessment reports may have subjective effects.

CONCLUSIONS

It was concluded that perceived EI might improve PTG in adolescents following the COVID-19 pandemic, and self-esteem and ER program training could be helpful in promoting PTG.

Latent Profiles of Posttraumatic Growth: 17 years After the Bam Earthquake in Iran

OBJECTIVE

Posttraumatic growth (PTG) is a positive psychological change after challenging life events. The purpose of this study was to investigate the effects of positive and long-term psychological changes in people who experienced the Bam earthquake.

METHODS

A total of 916 adolescents were surveyed 17 years after the earthquake. Self-report questionnaires were administered to participants. A latent profile analysis (LPA) was conducted to extract the subgroups of adults.

RESULTS

The LPA identified 5 meaningfully profiles that were characterized based on the pattern of PTG dimensions. The common profile was profile, which perceived very low "relating to others" dimension and medium for other PTG dimensions. Also, the results showed significant differences among gender and age and nonsignificant differences in marital status and education level among the profiles of PTG.

CONCLUSIONS

For stressful situations, the different dimensions of PTG change indirectly in every person. In Bam, some patterns are seen according to PTG after 17 y. Among these dimensions, the part of "relating to others", has the greatest change. Another conclusion is that according to a relatively high profile for 5 clusters, it seems the impact of 17 y should be less on PTG as the number of extractive patterns is approximately high for the case.

The Contributing Factors of Delayed-Onset Post-traumatic Stress Disorder Symptoms: A Nested Case-Control Study Conducted After the 2008 Wenchuan Earthquake

Background: Delayed-onset post-traumatic stress disorder after catastrophes is a major public health issue. However, good designs for identifying post-traumatic stress disorder (PTSD) among earthquake survivors are rare. This is the first nested case-control study to explore the possible factors associated with delayed-onset PTSD symptoms. Methods: A nested case-control study was conducted. The baseline (2011) and follow-up (2018) surveys were utilized to collect data. A total of 361 survivors of the Wenchuan earthquake were investigated and 340 survivors underwent follow-up. The survivors, from the hardest-hit areas, who met the criteria for PTSD were included in the case group, and PTSD-free survivors from the same area, matched for age, were included in the control group, with a ratio of one to four. Conditional logistic regression was used to evaluate the variables' odds ratio (OR). Results: The overall prevalence of delayed-onset PTSD symptoms in survivors of the Wenchuan earthquake was 9.7% (33/340). The unemployed earthquake survivors had a higher risk of developing delayed-onset PTSD symptoms (OR = 4.731, 95% CI = 1.408-15.901), while higher perceived social support was a protective factor against delayed-onset PTSD symptoms (OR = 0.172, 95% CI = 0.052-0.568). Conclusion: Delayed-onset PTSD symptoms, after a disaster, should not be ignored. Active social support and the provision of stable jobs can contribute to the earthquake survivors' mental health.

Relationship between post-traumatic disorder and posttraumatic growth in COVID-19 home-confined adolescents: The moderating role of self-efficacy

Although the COVID-19 pandemic has been traumatogenic for some people, posttraumatic growth (PTG) outcomes have also been observed. This study examined the PTG in adolescents and the moderating effect of self-efficacy on post-traumatic stress disorder (PTSD) symptoms and PTG. An online questionnaire was conducted on 2090 adolescent Chinese students to measure COVID-19 related exposure, self-efficacy, PTSD, and PTG. PTG prevalence was found in 20.6% of the sample, with the relationship between PTSD and PTG being found to be a reverse U-shaped curve. Objective exposure factors were found to be closely associated with PTSD symptoms but not with PTG. Similarly, subjective feelings of extreme fear were significantly associated with PTSD symptoms but not with PTG. Self-efficacy was found to be positively correlated with PTG (r = 0.551) and to moderate the relationship between PTSD and PTG. For those with low self-efficacy, the higher the PTSD, the higher the PTG, and for those with high self-efficacy, the higher the PTSD, the lower the PTG. As an improved sense of self-efficacy in adolescents could promote positive psychological transformations, these results could assist in identifying self-efficacy levels and providing guidance for targeted psychological interventions to promote positive growth.

COVID-19-related post-traumatic growth in the general public: a cross-sectional study from Yunnan, China

To investigate post-traumatic growth induced by COVID-19 pandemic in certain Yunnan residents and to analyze its influencing factors. A total of 581 permanent residents of Yunnan province completed the electronic questionnaire from 18 April 2020 to 26 April 2020. Logistic regression analysis showed that the educational levels, self-perceived health status, family history of infectious diseases, family history of infectious diseases, personality and frequency of going through COVID-19 related news were influencing factors of PTG (P < 0.05). As a traumatic event, the threat of COVID-19 may enable some people to gain positive psychological development in adversity. This will provide reference for public psychological crisis intervention following the COVID-19 pandemic.