Self-resilience as a protective factor against development of post-traumatic stress disorder symptoms in police officers

Traumatic stress, active engagement and resilience in first responders and civilians in the outbreak of war

Background: The outbreak of war in Israel on 7 October and the unique events of that day have presented unprecedented challenges to first responders (FRs), who are professionally trained to engage in providing assistance in such circumstances. Moreover, while research demonstrates the long-term psychological consequences of FRs, little is known regarding how FR's engagement in providing assistance relates to stress and resilience levels as events continue to unfold.Objective: The current study examined the relationship between traumatic stress symptoms (TSS) and resilience levels among FRs and controls during the first weeks of the Iron Swords war, while focusing on the moderating role of active engagement in providing assistance.Method: Data were collected during the first month of the Iron Swords war from 374 participants living in Southern Israel, of whom 77 (20.6%) were FRs. All participants filled out scales assessing TSS and resilience and provided relevant background information.Results: High TSS levels were associated with reduced resilience in FRs and non-FRs. Moreover, both the study group and active engagement were significant moderators for the TSS-resilience link, which was insignificant among FRs who provided assistance and for civilians who did not provide assistance. However, the TSS-resilience association remained significant for FRs who did not engage in providing assistance and for civilians who did.Conclusions: Our findings highlight the importance of examining the extent to which FRs act in line with their duties during times of adverse stress. Clinical interventions aimed towards FRs who did not engage in providing assistance are needed and should focus on the extent to which their moral values, beliefs and expectations are met, as these appear critical parameters in preserving resilience.

Role of Resilience in the Psychological Recovery of Women With Acute Myocardial Infarction

Background Psychological well-being is important among individuals with myocardial infarction (MI) given the clear links between stress, depression, and adverse cardiovascular outcomes. Stress and depressive disorders are more prevalent in women than men after MI. Resilience may protect against stress and depressive disorders after a traumatic event. Longitudinal data are lacking in populations post MI. We examined the role of resilience in the psychological recovery of women post MI, over time. Methods and Results We analyzed a sample from a longitudinal observational multicenter study (United States, Canada) of women post MI, between 2016 and 2020. Perceived stress (Perceived Stress Scale-4 [PSS-4]) and depressive symptoms (Patient Health Questionnaire-2 [PHQ-2]) were assessed at baseline (time of MI) and 2 months post MI. Demographics, clinical characteristics, and resilience (Brief Resilience Scale [BRS]) were collected at baseline. Low and normal/high resilience groups were established as per published cutoffs (BRS scores <3 or ≥3). Mixed-effects modeling was used to examine associations between resilience and psychological recovery over 2 months. The sample included 449 women, mean (SD) age, 62.2 (13.2) years, of whom 61.1% identified as non-Hispanic White, 18.5% as non-Hispanic Black, and 15.4% as Hispanic/Latina. Twenty-three percent had low resilience. The low resilience group had significantly higher PSS-4 and PHQ-2 scores than the normal/high resilience group at all time points. In adjusted models, both groups showed a decrease in PSS-4 scores over time. Conclusions In a diverse cohort of women post MI, higher resilience is associated with better psychological recovery over time. Future work should focus on developing strategies to strengthen resilience and improve psychological well-being for women with MI. Registration URL: https://clinicaltrials.gov/ct2/show/NCT02905357; Unique identifier: NCT02905357.

Psychiatric disorders among employment requiring firearms

Individuals who carry guns as a requirement of employment frequently experience hazards that can be stress inducing, violent, traumatizing, or cause personal injury. This study used data from the Collaborative Psychiatric Epidemiological Surveys (CPES; n = 20,013), to examine mental health diagnoses of individuals that ever worked at a job requiring a firearm. Consistent with existing literature, the findings indicated that those who worked in professions requiring a firearm showed similar risk of mental health diagnoses as law enforcement officers which includes symptoms of trauma, mood disorders, and alcohol use. Further, race/ethnic differences emerged in patterns of mental health diagnoses, suggesting sociocultural differences influence diagnoses. These findings indicate the necessity for further investigation of the understudied area of mental health of those within employment positions that require firearms.

Factors influencing post-traumatic stress disorder among police officers in South Korea

Objectives

This study aims to identify critical incident trauma (CIT), social support, resilience, and post-traumatic stress disorder (PTSD) in Korean police officers and to determine factors related to PTSD to obtain basic data for developing a PTSD intervention.

Methods

A mixed-methods approach was adopted by administering structured questionnaires to Korean police officers and conducting semi-structured interviews with seven Korean police stakeholders. The structured questionnaires elicited information on CIT, social support, resilience, and PTSD. Data from 189 participants were analyzed using independent t-tests, Pearson's correlation coefficients, and multiple linear regression analysis. The interview data, which elicited information on difficulties and coping strategies after CIT, police organizational culture, current status of counseling programs, and suggestions for PTSD interventions, were analyzed using an inductive thematic analysis.

Results

Factors that are significantly related to PTSD (28.7% of variance) are very healthy subjective health status (B = -0.44, p = 0.013), CIT (B = 0.18, p ≤ 0.001), social support (B = -0.38, p ≤ 0.001), and resilience (B = -0.18, p = 0.044). The stakeholders revealed the following PTSD-related factors: the difficulties and limitations of overcoming traumatic experiences, coping strategies, police counseling program status, and opinions on PTSD-related programs.

Conclusion

Perceived health status, CIT, social support, and resilience had a strong relationship with PTSD. Therefore, the success of PTSD interventions for Korean police officers should be considered.

Risk factors for stress among police officers: A systematic literature review

BACKGROUND

Stress is common among police personnel leading to several negative consequences.

OBJECTIVE

We performed a systematic literature review to identify risk factors for stress among police officers.

METHODS

We searched PubMed and Scopus electronic databases through to July 2018 and we conducted this review according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. The Newcastle-Ottawa scale was used for studies quality assessment.

RESULTS

After selection, 29 cross-sectional studies met the inclusion criteria and included in the review. The average quality of studies was low since no study was rated as having low risk of bias, three studies (10.3%) as moderate risk and 26 studies (89.7%) were rated as having high risk of bias. Stress risk factors were summarized in the following categories: demographic characteristics; job characteristics; lifestyle factors; negative coping strategies and negative personality traits.

CONCLUSIONS

Identification of stress risk factors is the first step to create and adopt the appropriate interventions to decrease stress among police personnel. The early identification of police officers at higher risk and the appropriate screening for mental health disorders is crucial to prevent disease and promote quality of life.

Network of correlations between quality of life, resilience and effort-reward imbalance in military police officers

OBJECTIVE

To analyze the network of correlations between the realms of the Effor t-Reward Imbalance (ERI) model, resilience, and quality of life among military police officers.

METHOD

This is a cross-sectional study conducted with 258 police officers from the Special Opera tions Battalion of the Military Police in a city in Rio Grande do Sul, Brazil. The scales of the ERI model, resilience, and World Health Quality of Life (WHOQOL-bref) assessed psychosocial stress, resilience, and quality of life. Descriptive and analytical statistics were performed em ploying the network analysis.

RESULTS

The realms of the ERI model and resilience correlated with all the WHOQOL's realms (p<0.001). The network model showed a negative association between effort, overcommitment, and physical and environmental realms. The environmental realm was positively associated with reward, while resilience was positively associated with the general, physical, and psychological realms.

CONCLUSION

We concluded that psychosocial stress interferes in the quality of life of military police officers, and resi lience may work as a protective factor.

Development and psychometric validation of the Dispositional Recovery and Dysfunction Inventory: a tool to assess for positive and negative cognitions following trauma exposure

BACKGROUND

Recovery from trauma can be naturally occurring or facilitated through psychotherapy. Few brief measures exist to provide clinicians with dispositional, empirical assessments of patient's sentiments during psychotherapy.

AIMS

This manuscript presents the Dispositional Recovery and Dysfunction Inventory (DRDI), a measure created to assist clinicians in evaluating patient's treatment progress during psychotherapy, as well as evaluate its factor structure, reliability estimates, measurement invariance, and correlates.

METHOD

The DRDI was created based on feedback from experts with experience treating posttraumatic stress disorder (PTSD) and was structurally validated in two distinct populations. Exploratory factor analysis was conducted in sample 1 consisting of (n=401) university students. Confirmatory factor analysis, measure validity and structure validation were then conducted in sample 2 (n=249) composed of 49% individuals with clinically significant PTSD symptoms.

RESULTS

Exploratory and confirmatory factor analysis revealed that the DRDI was best represented by a two-factor correlated traits model representing sentiments related to dispositional recovery and dysfunctional cognitions. The recovery subscale exhibited relationships with convergent measures including authenticity and psychological hardiness (r values of .30 to .60). The dysfunctional beliefs subscale exhibited relationships with convergent measures: PTSD, depression, suicidality and stress (r values of .55 to 80). Measurement invariance across gender and PTSD status was observed.

CONCLUSION

Initial findings indicate that the DRDI has the potential to be a useful tool to assess individuals' beliefs about their propensity to recover from and thrive through adversity.

Prevalence and Related Factors of Post-Traumatic Stress Disorder in Emergency Medical Technicians; a Cross-sectional Study

Introduction:

Ongoing exposure to a variety of Pre-hospital Emergencies (PE) has placed Emergency Medical Technicians (EMTs) at serious psychiatric compromise such as Post-Traumatic Stress Disorder (PTSD). The present study aimed to evaluate the prevalence and associated factors of PTSD among EMTs.

Methods:

This prospective cross-sectional study was conducted on EMTs in the Emergency Medical Services (EMS) in west of Iran. A baseline information questionnaire including personal work-related characteristics and the PTSD checklist of DSM-5 (PCL-5) were used for data collection. Non-parametric tests and multivariate linear regression were used to evaluate the associated factors of PTSD in these participants.

Results:

Among the participants, 22% of technicians had PTSD-diagnostic criteria. The mean total PCL-5 score was 21.60 ± 11.45, while the scores were 38.02 ± 6.08 and 17.47 ± 8.36 in the PTSD-diagnosed and undiagnosed groups, respectively. The most common symptom of the clusters was negative alterations in cognition with a mean score of 7.42 ± 4.63. After adjusting confounders, the number of missions (t= 2.50, P= 0.013), work experience (t= -3.24, P= 0.001) and number of shifts (t: 26.38, P < 0.001) were significantly corelated with PCL-5 score.

Conclusion:

The results indicated that the prevalence of PTSD among EMTs personnel of Hamedan province is high. EMTs with the age of ≤ 30 years, work experience of ≤ 10 years, married status, informal employment, emergency medical technician's degree, and more than 8 shifts per month, as well as no previous training history had a higher total PCL-5 score.

Post-Traumatic Stress Disorder in the Military Police of Rio de Janeiro: Can a Risk Profile Be Identified?

Background: Significant exposure to critical incidents characteristic of military police work has a potentially traumatic effect and multiple consequences for the mental health of these professionals, such as Post Traumatic Stress Disorder (PTSD). This study aims to investigate the occurrence of PTSD in this occupational group and its correlations with socio-demographic and occupational variables. Methods: This is a cross-sectional study of Rio de Janeiro’s Military Police officers (n = 3.577). Data was collected from self-reported questionnaires applied in an institutional health program. Post-Traumatic Stress Disorder Checklist—Civilian version was used to assess PTSD. Results: Rates of 16.9% for full PTSD and 26.7% for partial PTSD were found. Based on logistic regression analysis, female officers and police officers in lower ranks of the military hierarchy and performing administrative duties were found to be at most risk of developing PTSD. Conclusions: These results suggest the need to further understand the predictive organizational and individual variables of PTSD correlated with the increased vulnerability of professionals in order to contribute to institutional policies for the prevention and rehabilitation of these cases.

Posttraumatic stress disorder among adolescents in Brazil: a cross-sectional study

BACKGROUND

The frequency of trauma and different types of violence exposure in urban areas and their effects on the mental health of adolescents in developing countries are poorly investigated. Most information about traumatized young people comes from war scenarios or disasters. This study aimed to determine the prevalence of PTSD in trauma-exposed students in a low-resource city of the state of Rio de Janeiro, Brazil. The effects of sociodemographic and individual and family factors in the development of PTSD were also investigated.

METHODS

Through multi-stage cluster sampling, 862 adolescents (Mage = 15 years old, 65% female) from public and private schools in the city of São Gonçalo were selected for the study. Self-rating structured questionnaires were applied to assess sociodemographic profile, exposure to physical and psychological violence (family, school, community), sexual abuse, social support, social functional impairment, resilience, and posttraumatic stress disorder. The data were grouped in blocks regarding sociodemographic, individual, family, and community variables. For statistical analysis, chi-square, Fisher's exact test, and logistic regression were performed.

RESULTS

The PTSD prevalence was 7.8% among adolescents. Boys were exposed to significantly higher number of events of community violence, while girls to family violence. The adjusted odds ratio (OR) for PTSD were statistically significant for age (OR, 1.45, [95% CI, 1.043-2.007]), social functional impairment (OR, 4.82, [95% CI, 1.77-13.10]), severe maternal physical violence (OR, 2.79, [95% CI, 0.79-9.93]), psychological violence by significant people (OR, 3.96, [95% CI, 1.89-8.31]) and a high number of episodes of community violence (OR, 3.52, [95% CI, 1.47-8.40).

CONCLUSIONS

There was a high prevalence of PTSD within this population associated with exposure to violence. Not only physical, but also psychological violence contributed to PTSD. The results also raise awareness to the differences in life trajectories between boys and girls regarding violence. These differences need to be better understood in order to enable the development of effective preventative interventions. Treating and preventing mental health disorders presents a challenge for countries, especially those with a lower degree of social and economic development and high community violence.

Characteristics of Resilience Among Disaster Rescue Workers: A Systematic Review

Disasters can cause long-lasting damage to survivors and rescue workers. Some rescue workers suffer negative physical and psychological consequences, while others do not. Thus, it is of value to fully understand the characteristics of rescuers who have not been affected by rescue activities. Resilience refers to the ability or capacity to cope with adversity. The aim of this review is to explore and identify the characteristics of resilience among rescue workers. A systematic literature search was conducted of seven electronic databases from inception to May 2019, using keywords and medical subject heading terms related to the resilience of rescuers. Hand searches and searches of leading authors were also performed. A total of 31 articles were eligible for review. Six domains were identified to characterize the resilience of rescuers namely, demographic and physical characteristics, personality traits, coping strategies, perceived resources, being equipped with special skills for disaster rescue, and having less adverse consequences from exposure to disaster. Researchers and disaster managers can take note of these characteristics to comprehensively understand the 'positive concept' of resilience. This enhanced understanding of 'positive resilience' can in turn be used to develop a framework to assess and establish interventions, and consequently to improve the psychological wellbeing of rescuers after disaster rescue efforts.

Resilience and cortical thickness: a MRI study

Resilience is defined as the psychological resistance which enables the processing of stress and adverse life events and thus constitutes a key factor for the genesis of psychiatric illness. However, little is known about the morphological correlates of resilience in the human brain. Hence, the aim of this study is to examine the neuroanatomical expression of resilience in healthy individuals. 151 healthy subjects were recruited and had to complete a resilience-specific questionnaire (RS-11). All of them underwent a high-resolution T1-weighted MRI in a 3T scanner. Fine-grained cortical thickness was analyzed using FreeSurfer. We found a significant positive correlation between the individual extent of resilience and cortical thickness in a right hemispherical cluster incorporating the lateral occipital cortex, the fusiform gyrus, the inferior parietal cortex as well as the middle and inferior temporal cortex, i.e., a reduced resilience is associated with a decreased cortical thickness in these areas. We lend novel evidence for a direct linkage between psychometric resilience and local cortical thickness. Our findings in a sample of healthy individuals show that a lower resilience is associated with a lower cortical thickness in anatomical areas are known to be involved in the processing of emotional visual input. These regions have been demonstrated to play a role in the pathogenesis of stress and trauma-associated disorders. It can thus be assumed that neuroanatomical variations in these cortical regions might modulate the susceptibility for the development of stress-related disorders.

Systematic review of posttraumatic stress disorder in police officers following routine work-related critical incident exposure

BACKGROUND

The prevalence of PTSD in police officers has been the subject of a large and highly variable empirical literature. The present systematic review evaluates the extant literature on PTSD in police officers using an international dataset.

METHODS

We employed best-evidence narrative synthesis to evaluate whether PTSD prevalence in police is elevated in comparison to the general population of Canada (8%), which itself has a higher lifetime PTSD prevalence than many other regions and thus serves as a conservative standard of comparison.

RESULTS

PTSD prevalence in police varied considerably across studies from 0% - 44% (M = 14.87%, Median = 9.2%). Despite this variability, strong evidence exists to suggest PTSD prevalence is elevated in police officers. Examination of possible sources of variability in prevalence outcomes highlighted substantial variability in outcomes due to the selection of measurement tool for assessing PTSD (e.g., DSM vs. IES). Examination of commonly-assessed predictive factors for PTSD risk across the literature showed that individual-difference factors (e.g., age, years of service) bear weak-to-nonexistent relationships with PTSD risk, while incident-specific factors (e.g., severity of exposure) are more strongly and consistently associated with PTSD prevalence. Organizational factors (e.g., low support from supervisor) are at present understudied but important possible contributors to PTSD risk.

CONCLUSIONS

PTSD prevalence is elevated in police officers and appears most strongly related to workplace exposure. Measurement variability remains a critical source of inconsistencies across the literature with drastic implications for accurate detection of officers in need of mental health intervention.

Occupational post-traumatic stress disorder: an updated systematic review

BACKGROUND

Although numerous studies on occupational post-traumatic stress disorder (PTSD) have been conducted prior to the 1950-2010 seminal systematic review by Skogstad et al., the prevalence, risk factors, and impact of this disorder following traumatic events in occupational settings remain unclear. This study aims to address this knowledge gap by reviewing the literature published after 2010.

METHODS

We reviewed literature from databases such as PubMed and Google Scholar using PRISMA guidelines to identify studies that address occupational PTSD and examined the status (prevalence or incidence), the risk factors, and the health effects of PTSD among workers.

RESULTS

In total, 123 articles were identified, and finally, 31 (25.2%) articles were selected after excluding duplicates. Various occupational traumatic physical events were reported such as natural or manmade disaster, explosion, accident, handling refugee corpses, or bullying at work. Risk of PTSD was closely associated with working conditions, severity of injury, history of mental disorder, occurrence of psychiatric symptoms at the time of the event, personality, interpersonal relationships, etc. Workers with PTSD were likely to experience a deterioration of physical and psychological health and impairment of social and occupational functioning.

CONCLUSIONS

Our review suggests that many workers remain highly vulnerable to occupational PTSD and its consequences.

Global prevalence and risk factors for mental health problems in police personnel: a systematic review and meta-analysis

Police face an increased risk of developing mental health problems, yet reliable estimates of their psychological difficulties remain unknown. This systematic review and meta-analysis estimate the pooled prevalence and risk factors for mental health problems among police personnel worldwide. Three independent reviewers searched 16 databases and screened 11 506 articles published between January 1980 and October 2019. Eligible studies involved at least 100 active police professionals and used validated instruments to ascertain specific mental health problems. Estimates were pooled using random-effects meta-analyses. In total, 60 cross-sectional and seven longitudinal studies, involving 272 463 police personnel from 24 countries met criteria for inclusion. The overall pooled point prevalence was 14.6% for depression (95% CI 10.9% to 18.6%), 14.2% for post-traumatic stress disorder (PTSD; 95% CI 10.3% to 18.7%), 9.6% for a generalised anxiety disorder (95% CI 6.7% to 12.9%), 8.5% for suicidal ideation (95% CI 6.1% to 11.2%), 5.0% for alcohol dependence (95% CI 3.5% to 6.7%) and 25.7% for hazardous drinking (95% CI 19.6% to 32.4%). The strongest risk factor for depression and suicidal ideation was higher occupational stress, and the strongest risk factors for PTSD were higher occupational stress and avoidant coping strategies. Higher levels of peer-support were associated with significantly lower PTSD symptoms. Our findings suggest that the prevalence of mental health problems among police exceeds twice that previously reported in mixed samples of first responders, and is associated with poor social support, occupational stress and maladaptive coping strategies. Without effective intervention, psychological difficulties will remain a substantial health concern among police.

Associations between changes in resilient coping and posttraumatic stress disorder symptoms

The pervasive, damaging nature of posttraumatic stress disorder (PTSD) presents enormous clinical challenges. Understanding the relationship between patients' perceptions of PTSD symptoms and resilient coping strategies may prompt investigation of clinical interventions that improve adaptive, resilient coping skills. In this study, we examined whether changes in resilient coping were related to changes over time in the PTSD symptoms of intrusion and avoidance. A secondary analysis was conducted using longitudinal data from the community-based Washington State Twin Registry. Participants completed the four-item Brief Resilient Coping Scale (BRCS) and the Avoidance and Intrusion subscales of the Impact of Events Scale (IES) at two points in time that were at least 2 years apart. To limit analyses to participants reporting PTSD symptoms at baseline, an initial value of at least 1.0 on either Avoidance (n = 1,337) or Intrusion (n = 1,206) was required for inclusion in the sample. Using linear regression, we assessed associations of change in BRCS with a change in IES scores, controlling for the respective initial scores on each measure. Controlling for initial BRCS and IES-Intrusion values, we observed a small, statistically significant association between change in BRCS and change in IES-Intrusion scores (b* = -0.07; p = .003). There was no statistically significant association between change in BRCS and change in IES-Avoidance (b* < 0.01; p = .869). In this large, longitudinal sample, increases in resilient coping were related to decreases in intrusive thoughts over time. Because coping patterns can be taught, these results warrant further investigations into adaptive coping patterns associated with diminishing PTSD symptoms.

Resilience as a Protective Factor for Suicidal Ideation among Korean Workers

OBJECTIVE

This study aimed to investigate resilience as a protective factor for suicidality among Korean workers.

METHODS

Participants were workers from 26 organizations in Korea, aged 18 to 63 years, who completed a self-reported questionnaire comprising items on sociodemographic factors, job stress, resilience, and suicidality. Completed questionnaires were collected from 4,405 persons, with 4,389 valid responses. Hierarchical logistic regression analyses were performed using suicidality as the dependent variable.

RESULTS

Results of the logistic regression analyses indicated that among the sociodemographic factors, older age, being female, and being single were statistically significantly associated with suicidal ideation. A high level of job stress, depressive mood, and anxiety, in addition to a short job duration, were also associated with suicidal ideation. Resilience was a significant protective factor for suicidal ideation after adjusting for all other variables. Older age and high anxiety levels were associated with having a suicide plan among participants with suicidal ideation. The association of resilience with suicide plans and suicide attempts was non-significant.

CONCLUSION

In this study, we found that a high level of resilience was associated with a low incidence of suicidal ideation in Korean workers. Based on these results, we suggest the need to develop and implement interventions to improve resilience in the workplace, thereby protecting workers, especially those with a high level of work stress, from suicidal ideation.

Identifying the Key Risk Factors for Adverse Psychological Outcomes Among Police Officers: A Systematic Literature Review

It is well established that police work is highly stressful; however, a paucity of evidence limits our knowledge and understanding of the factors that may lead to, compromise, and/or compound psychological distress for this unique population. To address this lack, the current systematic review was conducted to reveal the individual, organizational, and operational risk factors that have been identified in the research literature to date and their associations with depression, anxiety, posttraumatic stress disorder (PTSD), and burnout. We performed searches on literature published between January 2008 and January 2018 and identified a total of 20 studies that met our inclusion criteria. The results indicated that individual factors, including high levels of neuroticism, low social support, and engaging in passive or avoidant coping strategies, were associated with adverse psychological outcomes. This review identified low social support from colleagues as the most common risk factor linked to adverse psychological outcomes. Other organizational risk factors associated with such outcomes included high work demands, low resources, and low reward. This article demonstrates that individual, organizational, and operational factors all impact the negative psychological outcomes of police officers to some degree. In particular, the current review suggests that certain negative psychological outcomes are likely a result of a combination of risk factors across the three domains of risk, highlighting the necessity to observe psychological risk of police in a more comprehensive way.

Machine-learning-based classification between post-traumatic stress disorder and major depressive disorder using P300 features

BACKGROUND

The development of optimal classification criteria for specific mental disorders which share similar symptoms is an important issue for precise diagnosis. We investigated whether P300 features in both sensor-level and source-level could be effectively used to classify post-traumatic stress disorder (PTSD) and major depressive disorder (MDD).

METHOD

EEG signals were recorded from fifty-one PTSD patients, 67 MDD patients, and 39 healthy controls (HCs) while performing an auditory oddball task. Amplitude and latency of P300 were evaluated, and the current source analysis of P300 components was conducted using sLORETA. Finally, we classified two groups using machine-learning methods with both sensor- and source-level features. Moreover, we checked the comorbidity effects using the same approaches (PTSD-mono diagnosis (PTSDm, n = 28) and PTSD-comorbid diagnosis (PTSDc, n = 23)).

RESULTS

PTSD showed significantly reduced P300 amplitudes and prolonged latency compared to HCs and MDD. Moreover, PTSD showed significantly reduced source activities, and the source activities were significantly correlated with symptoms of depression and anxiety. Also, the best classification accuracy at each pair was as follows: 80.00% (PTSD-HCs), 67.92% (MDD-HCs), 70.34% (PTSD-MDD), 82.09% (PTSDm-HCs), 71.58% (PTSDm-MDD), 82.56% (PTSDc-HCs), and 76.67% (PTSDc- MDD).

CONCLUSION

Since abnormal P300 reflects pathophysiological characteristics of PTSD, PTSD patients were well-discriminated from MDD and HCs when using P300 features. Thus, altered P300 characteristics in both sensor- and source-level may be useful biomarkers to diagnosis PTSD.

Resilience as a Protective Factor for Depressive Mood and Anxiety among Korean Employees

BACKGROUND

This study aimed to investigate resilience as a protective factor for depressive mood and anxiety among Korean employees.

METHODS

Participants were employees of eight private and local government organizations in Korea, aged 19 to 65 years. A self-report questionnaire that included items on resilience, job stress, levels of depression and anxiety, and socio-demographic factors, was administered to 1,079 Korean employees, with 1,076 valid responses. We performed hierarchical linear regression analyses with the levels of depression and anxiety scores as dependent variables.

RESULTS

Being women and having a high level of job stress were associated with greater depressive mood and anxiety. In contrast, resilience was negatively related to depressive mood and anxiety, after adjusting for demographic variables and the level of job stress. Among the five factors for resilience, "support" and "hardiness" were protective factors for depressive mood and anxiety after adjusting for demographic variables and the level of job stress.

CONCLUSION

Based on the results of the current study, we suggest that focusing on the resilience of employees, especially on "support" and "hardiness," factors as well as developing and engaging in interventions that increase resilience in the workplace, can protect against depressive mood and anxiety, especially for those with high levels of job stress.

Accelerated DNA methylation aging and increased resilience in veterans: The biological cost for soldiering on

Accelerated epigenetic aging, the difference between the DNA methylation-predicted age (DNAm age) and the chronological age, is associated with a myriad of diseases. This study investigates the relationship between epigenetic aging and risk and protective factors of PTSD. Genome-wide DNA methylation analysis was performed in 211 individuals including combat-exposed Australian veterans (discovery cohort, n = 96 males) and trauma-exposed civilian males from the Grady Trauma Project (replication cohort, n = 115 males). Primary measures included the Clinician Administered PTSD Scale for DSM-5 and the Connor-Davidson Resilience Scale (CD-RISC). DNAm age prediction was performed using the validated epigenetic clock calculator. Veterans with PTSD had increased PTSD symptom severity (P-value = 3.75 × 10-34) and lower CD-RISC scores (P-value = 7.5 × 10-8) than veterans without PTSD. DNAm age was significantly correlated with the chronological age (P-value = 3.3 × 10-6), but DNAm age acceleration was not different between the PTSD and non-PTSD groups (P-value = 0.24). Evaluating potential protective factors, we found that DNAm age acceleration was significantly associated with CD-RISC resilience scores in veterans with PTSD, these results remained significant after multiple testing correction (P-value = 0.023; r = 0.32). This finding was also replicated in an independent trauma-exposed civilian cohort (P-value = 0.02; r = 0.23). Post-hoc factor analyses revealed that this association was likely driven by "self-efficacy" items within the CD-RISC (P-value = 0.015; r = 0.35). These results suggest that among individuals already suffering from PTSD, some aspects of increased resilience might come at a biological cost.