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Figueroa RA, Cortés PF, Miller C, Marín H, Gillibrand R, Hoeboer CM, Olff M. The effect of a single session of psychological first aid in the emergency department on PTSD and depressive symptoms three months post-intervention: results of a randomised controlled trial. Eur J Psychotraumatol 2024; 15:2364443. [PMID: 38949539 PMCID: PMC11218590 DOI: 10.1080/20008066.2024.2364443] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2023] [Accepted: 05/12/2024] [Indexed: 07/02/2024] Open
Abstract
Background: Despite its popularity, evidence of the effectiveness of Psychological First Aid (PFA) is scarce.Objective: To assess whether PFA, compared to psychoeducation (PsyEd), an attention placebo control, reduces PTSD and depressive symptoms three months post-intervention.Methods: In two emergency departments, 166 recent-trauma adult survivors were randomised to a single session of PFA (n = 78) (active listening, breathing retraining, categorisation of needs, assisted referral to social networks, and PsyEd) or stand-alone PsyEd (n = 88). PTSD and depressive symptoms were assessed at baseline (T0), one (T1), and three months post-intervention (T2) with the PTSD Checklist (PCL-C at T0 and PCL-S at T1/T2) and the Beck Depression Inventory-II (BDI-II). Self-reported side effects, post-trauma increased alcohol/substance consumption and interpersonal conflicts, and use of psychotropics, psychotherapy, sick leave, and complementary/alternative medicine were also explored.Results: 86 participants (51.81% of those randomised) dropped out at T2. A significant proportion of participants in the PsyEd group also received PFA components (i.e. contamination). From T0 to T2, we did not find a significant advantage of PFA in reducing PTSD (p = .148) or depressive symptoms (p = .201). However, we found a significant dose-response effect between the number of delivered components, session duration, and PTSD symptom reduction. No significant difference in self-reported adverse effects was found. At T2, a smaller proportion of participants assigned to PFA reported increased consumption of alcohol/substances (OR = 0.09, p = .003), interpersonal conflicts (OR = 0.27, p = .014), and having used psychotropics (OR = 0.23, p = .013) or sick leave (OR = 0.11, p = .047).Conclusions: Three months post-intervention, we did not find evidence that PFA outperforms PsyEd in reducing PTSD or depressive symptoms. Contamination may have affected our results. PFA, nonetheless, appears to be promising in modifying some post-trauma behaviours. Further research is needed.
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Affiliation(s)
- Rodrigo Andrés Figueroa
- Neuroscience Division, Department of Psychiatry, Pontificia Universidad Católica de Chile School of Medicine, Santiago, Chile
- Department of Psychiatry, Amsterdam Neuroscience, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
- Research Centre for Integrated Natural Disaster Management (Cigiden), Santiago, Chile
| | | | - Carolina Miller
- Pontificia Universidad de Chile School of Psychology, Santiago, Chile
| | - Humberto Marín
- Neuroscience Division, Department of Psychiatry, Pontificia Universidad Católica de Chile School of Medicine, Santiago, Chile
- Research Centre for Integrated Natural Disaster Management (Cigiden), Santiago, Chile
| | - Rodrigo Gillibrand
- Hospital Del Trabajador, Asociación Chilena de Seguridad, Providencia, Chile
| | - Chris Maria Hoeboer
- Department of Psychiatry, Amsterdam Neuroscience, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
| | - Miranda Olff
- Department of Psychiatry, Amsterdam Neuroscience, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
- ARQ National Psychotrauma Centre, Diemen, The Netherlands
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Fan X, Ning K, Ma TSW, Aung Y, Tun HM, Thin Zaw PP, Flores FP, Chow MSC, Leung CMC, Lun P, Chang WC, Leung GM, Ni MY. Post-traumatic stress, depression, and anxiety during the 2021 Myanmar conflict: a nationwide population-based survey. THE LANCET REGIONAL HEALTH. SOUTHEAST ASIA 2024; 26:100396. [PMID: 38617087 PMCID: PMC11007429 DOI: 10.1016/j.lansea.2024.100396] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Revised: 11/24/2023] [Accepted: 03/15/2024] [Indexed: 04/16/2024]
Abstract
Background The UN warns that Myanmar faces the 'triple crises' of mass conflict, uncontrolled COVID-19, and economic collapse. Therefore, we aimed to assess the population mental health burden, healthcare needs, and the associated risk factors in Myanmar. Methods We established a nationwide random sample and recruited 1038 adults via random digit dialling from July 3-Aug 9, 2021, during the ongoing conflict since Feb 1, 2021, and surge in SARS-CoV-2 infections. Probable post-traumatic stress disorder (PTSD) was assessed using the PTSD Checklist-Civilian Version. Probable depression and anxiety were assessed using the Patient Health Questionnaire-2 and the Generalized Anxiety Disorder-2. We calculated population attributable fractions for probable mental disorders using multivariable logistic regression models. Based on the mental health burden and healthcare-seeking patterns, we projected the need for mental health services. Findings During the 'triple crises', a third of adults in Myanmar (34.9%, 95% CI 32.0-37.7) reported a probable mental disorder. Prevalence of probable PTSD, depression, and anxiety were 8.1% (6.6-9.7), 14.3% (12.0-16.6), and 22.2% (19.7-24.7), respectively. We estimated that up to 79.9% (43.8-97.9) of probable PTSD was attributable to political stress. This corresponds to 2.1 million (1.1-3.2 million) fewer adults with probable PTSD if political stress was removed from the population. The mental health burden could translate into roughly 5.9 million adults seeking mental health services. Interpretation The mental health burden in Myanmar is substantial, and population mental health might only be restored when the three crises have ended. An accelerated peace process is critical to protecting Myanmar's population mental health. Funding This research was supported the Research Grants Council of the Hong Kong Special Administrative Region, China (Project No. HKU 17606122) and the Michele Tansella Award.
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Affiliation(s)
- Xiaoyan Fan
- School of Public Health, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
| | - Ke Ning
- School of Public Health, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
| | - Tiffany SW. Ma
- School of Public Health, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
| | - Yadanar Aung
- Institute for Population and Social Research, Mahidol University, Bangkok, Thailand
| | - Hein Min Tun
- The Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
- Microbiota I-Center (MagIC), The Chinese University of Hong Kong, Hong Kong SAR, China
- Li Ka Shing Institute of Health Sciences, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
- HKU-Pasteur Research Pole, School of Public Health, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
| | - Phyu Phyu Thin Zaw
- School of Public Health, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
| | - Francis P. Flores
- School of Public Health, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
| | - Mathew SC. Chow
- School of Public Health, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
| | - Candi MC. Leung
- School of Public Health, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
| | - Phyllis Lun
- School of Public Health, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
| | - Wing Chung Chang
- Department of Psychiatry, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
- The State Key Laboratory of Brain and Cognitive Sciences, The University of Hong Kong, Hong Kong SAR, China
| | - Gabriel M. Leung
- School of Public Health, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
- Laboratory of Data Discovery for Health (D4H), Hong Kong Science Park, Hong Kong SAR, China
| | - Michael Y. Ni
- School of Public Health, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
- The State Key Laboratory of Brain and Cognitive Sciences, The University of Hong Kong, Hong Kong SAR, China
- Urban Systems Institute, The University of Hong Kong, Hong Kong SAR, China
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Öz E, Küçükkelepçe O, Kurt O, Kapıcı Y. The relationship between earthquake-induced post-traumatic stress disorder and breastfeeding attitude and behavior. BMC Psychiatry 2024; 24:343. [PMID: 38714972 PMCID: PMC11075360 DOI: 10.1186/s12888-024-05803-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2024] [Accepted: 04/30/2024] [Indexed: 05/12/2024] Open
Abstract
BACKGROUND This study aimed to investigate the prevalence and severity of post-traumatic stress disorder (PTSD) and analyze the relationship between PTSD and breastfeeding attitudes and behaviors among breastfeeding mothers and women with children aged 0-24 months, all of whom had experienced the earthquake. METHODS In this cross-sectional survey, a face-to-face questionnaire was administered to 173 earthquake survivors in Adıyaman, Turkey, during June and July 2023. The PTSD Checklist-Civilian scale was used to assess the presence of PTSD, while the Breastfeeding Attitudes of the Evaluation Scale (BAES) was employed to evaluate breastfeeding behaviors in mothers. RESULTS Significantly higher PTSD scores (47.6 ± 17.4) were found among women staying in tents, while lower scores (37.0 ± 16.4) were observed in those who continued breastfeeding. 78.6% of women reported decreased breast milk because of the earthquake. Mothers with reduced milk supply had higher PTSD scores (46.1 ± 17.3). Breastfeeding training was associated with higher BAES scores (106.8 ± 56.8) and lower PTSD scores (32.5 ± 11.0). A significant negative correlation was observed between the PTSD score and BAES (r = -0.742; p < 0.001). CONCLUSIONS The study demonstrated that breastfeeding may protect mothers against PTSD in the aftermath of earthquakes, emphasizing the importance of breastfeeding education. The higher frequency and severity of PTSD observed among earthquake survivor mothers residing in tents underscores the importance of promptly transitioning to permanent housing after the earthquake.
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Affiliation(s)
- Erdoğan Öz
- Adıyaman Provincial Health Directorate, Adıyaman, Türkiye
| | | | - Osman Kurt
- Adıyaman Provincial Health Directorate, Adıyaman, Türkiye
| | - Yaşar Kapıcı
- Faculty of Medicine, Department of Psychiatry, Adıyaman University, Adıyaman, Türkiye.
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Villalba-Arias J, Estigarribia G, Bogado JA, Méndez J, Toledo S, Barrios I, Castaldelli-Maia JM, Ventriglio A, Torales J. Mental health issues and psychological risk factors among Paraguayan healthcare workers during the COVID-19 pandemic. J Ment Health 2023; 32:1065-1072. [PMID: 34586935 DOI: 10.1080/09638237.2021.1979494] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2021] [Revised: 07/13/2021] [Accepted: 08/29/2021] [Indexed: 12/28/2022]
Abstract
BACKGROUND There is an increasing concern regarding the mental health of healthcare workers during the COVID-19 pandemic. AIMS This study aimed to assess the psychological impact of the COVID-19 exposure among Paraguayan healthcare workers. METHODS A cross-sectional descriptive study has been carried out in five hospitals of Paraguay. Demographic and occupational exposure to COVID-19 were collected through a short questionnaire. Mental health status was assessed with the GAD-7, the PHQ-9, and the PCL-C. Logistic regression was used to determine psychological risk factors. RESULTS 432 participants were surveyed. 218 (50.46%) were physicians. The prevalence of symptoms of anxiety, depression and PTSD was 48.15, 41.90, and 5.79%, respectively. There were no significant differences in anxiety (128 [29.63%] vs. 80 [18.52%]; p = 0.3303), depression (102 [23.61%] vs. 79 [18.29%]; p = 0.6703), or PTSD (14 [3.24%] vs. 11 [2.55%]; p = 0.8074) between frontline versus second-line workers. Main risk factors associated with psychological distress included work experience <5 years for depression and a COVID-19 positive diagnosis or having family/friends with a COVID-19 positive diagnosis for PTSD. CONCLUSIONS Paraguayan healthcare workers reported high prevalence of anxiety, depression, and a low prevalence of PTSD. A positive diagnosis of COVID-19 and work experience <5 years are important psychological risk factors.
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Affiliation(s)
- Jorge Villalba-Arias
- Department of Psychiatry (Santa Rosa Campus), Santa Rosa del Aguaray, National University of Asunción, Asunción, Paraguay
| | - Gladys Estigarribia
- Department of Psychiatry (Santa Rosa Campus), Santa Rosa del Aguaray, National University of Asunción, Asunción, Paraguay
| | - José Andrés Bogado
- Department of Psychiatry (Santa Rosa Campus), Santa Rosa del Aguaray, National University of Asunción, Asunción, Paraguay
| | - Julieta Méndez
- Regional Institute for Health Research, National University of Caaguazú, Coronel Oviedo, Paraguay
| | - Santiago Toledo
- Department of Psychiatry (Santa Rosa Campus), Santa Rosa del Aguaray, National University of Asunción, Asunción, Paraguay
| | - Iván Barrios
- Department of Psychiatry, National University of Asunción, San Lorenzo, Paraguay
| | - João Mauricio Castaldelli-Maia
- Department of Neuroscience, Medical School, Fundação do ABC, Santo André, SP, Brazil
- Department of Psychiatry, Medical School, University of São Paulo, São Paulo, SP, Brazil
| | - Antonio Ventriglio
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - Julio Torales
- Department of Psychiatry, National University of Asunción, San Lorenzo, Paraguay
- Department of Social Anthropology (Santa Rosa Campus), Santa Rosa del Aguaray, National University of Asunción, Asunción, Paraguay
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Keles A, Karayagmurlu A, Yetkin E, Sonmez K, Karatepe MS, Karaman SK. Development of posttraumatic stress disorder and depression after open globe injury in adults. Graefes Arch Clin Exp Ophthalmol 2023; 261:257-262. [PMID: 35939121 DOI: 10.1007/s00417-022-05792-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2022] [Revised: 07/21/2022] [Accepted: 07/29/2022] [Indexed: 01/04/2023] Open
Abstract
PURPOSE To investigate the prevalence of posttraumatic stress disorder (PTSD) and depression after open globe injury in adults. METHODS A total of 95 participants, 43 adult patients with open globe injury and 52 age-sex similar subjects (control group), were included in this cross-sectional study. Age, gender, education level, occupation, accident history, psychiatric history, trauma type, cause of trauma, and visual acuity were recorded. One to six months after trauma, PTSD and depression symptoms of the participants were evaluated with the Posttraumatic Stress Disorder Questionnaire-Civil Version Scale (PTSD-S) and Beck Depression Inventory (BDI), respectively. RESULTS Patients with open globe injury had a higher PTSD-S total score than the control group, but not significant (23.67 ± 20.41 vs. 18.56 ± 13.13, p = 0.580). Patients with eye trauma exhibited a much higher prevalence of PTSD compared to the control group (20.9% vs. 3.8%, p = 0.010). Patients with trauma had a significantly higher BDI total score than the control group (12.47 ± 10.08 vs. 7.69 ± 6.10, p = 0.015). Also, patients had a higher rate of depression symptoms than controls (25.6% vs. 7.7%, p = 0.017). A significant positive correlation was observed between PTSD-S and BDI scores in the trauma group (r = 0.720, p < 0.001). CONCLUSION An increased prevalence of PTSD and depression was observed in adults after open globe injury. The significant relationship between PTSD-S and BDI scores indicates that patients with open globe injuries should be questioned in terms of both symptoms. For patients with open globe trauma, a holistic approach with psychosocial assessment in addition to physical intervention would be beneficial.
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Affiliation(s)
- Ali Keles
- Department of Ophthalmology, Faculty of Medicine, Bilecik Seyh Edebali University, 11230, Bilecik, Turkey.
| | - Ali Karayagmurlu
- Department of Child and Adolescent Psychiatry, Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Esat Yetkin
- Department of Ophthalmology, Faculty of Medicine, Adiyaman University, Adiyaman, Turkey
| | - Kenan Sonmez
- Department of Ophthalmology, University of Health Sciences, Ulucanlar Eye Training and Research Hospital, Ankara, Turkey
| | - Mustafa Salih Karatepe
- Department of Ophthalmology, Faculty of Medicine, Sivas Cumhuriyet University, Sivas, Turkey
| | - Suleyman Korhan Karaman
- Department of Ophthalmology, University of Health Sciences, Ulucanlar Eye Training and Research Hospital, Ankara, Turkey
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Hoffman J, Ben-Zion Z, Arévalo A, Duek O, Greene T, Hall BJ, Harpaz-Rotem I, Liddell B, Locher C, Morina N, Nickerson A, Pfaltz MC, Schick M, Schnyder U, Seedat S, Shatri F, Sit HF, von Känel R, Spiller TR. Mapping the availability of translated versions of posttraumatic stress disorder screening questionnaires for adults: A scoping review. Eur J Psychotraumatol 2022; 13:2143019. [PMID: 38872602 PMCID: PMC9724641 DOI: 10.1080/20008066.2022.2143019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Accepted: 10/26/2022] [Indexed: 11/26/2022] Open
Abstract
Background: The most used questionnaires for PTSD screening in adults were developed in English. Although many of these questionnaires were translated into other languages, the procedures used to translate them and to evaluate their reliability and validity have not been consistently documented. This comprehensive scoping review aimed to compile the currently available translated and evaluated questionnaires used for PTSD screening, and highlight important gaps in the literature.Objective: This review aimed to map the availability of translated and evaluated screening questionnaires for posttraumatic stress disorder (PTSD) for adults.Methods: All peer-reviewed studies in which a PTSD screening questionnaire for adults was translated, and which reported at least one result of a qualitative and /or quantitative evaluation procedure were included. The literature was searched using Embase, MEDLINE, and APA PsycInfo, citation searches and contributions from study team members. There were no restrictions regarding the target languages of the translations. Data on the translation procedure, the qualitative evaluation, the quantitative evaluation (dimensionality of the questionnaire, reliability, and performance), and open access were extracted.Results: A total of 866 studies were screened, of which 126 were included. Collectively, 128 translations of 12 different questionnaires were found. Out of these, 105 (83.3%) studies used a forward and backward translation procedure, 120 (95.2%) assessed the reliability of the translated questionnaire, 60 (47.6%) the dimensionality, 49 (38.9%) the performance, and 42 (33.3%) used qualitative evaluation procedures. Thirty-four questionnaires (27.0%) were either freely available or accessible on request.Conclusions: The analyses conducted and the description of the methods and results varied substantially, making a quality assessment impractical. Translations into languages spoken in middle- or low-income countries were underrepresented. In addition, only a small proportion of all translated questionnaires were available. Given the need for freely accessible translations, an online repository was developed.HIGHLIGHTS We mapped the availability of translated PTSD screening questionnaires.The quality of the translation and validation processes is very heterogenous.We created a repository for translated, validated PTSD screening questionnaires.
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Affiliation(s)
- Joel Hoffman
- School of Psychology, UNSW Australia, Sydney, Australia
| | - Ziv Ben-Zion
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
- US Department of Veterans Affairs National Center for PTSD, VA Connecticut, Healthcare System, West Haven, CT, USA
| | - Adrián Arévalo
- Facultad de Medicina & Neuron Research Group Lima, Universidad de Piura, Lima, Perú
- Facultad de Medicina "San Fernando", Universidad Nacional Mayor de San Marcos, Lima, Perú
| | - Or Duek
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
- US Department of Veterans Affairs National Center for PTSD, VA Connecticut, Healthcare System, West Haven, CT, USA
| | - Talya Greene
- Department of Community Mental Health, University of Haifa, Haifa, Israel
| | - Brian J Hall
- Center for Global Health equity, New York University (Shanghai), Shanghai, People's Republic of China
- School of Global Public Health, New York University, New York, NY, USA
| | - Ilan Harpaz-Rotem
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
- US Department of Veterans Affairs National Center for PTSD, VA Connecticut, Healthcare System, West Haven, CT, USA
| | | | - Cosima Locher
- Department of Consultation-Liaison Psychiatry and Psychosomatic Medicine, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Naser Morina
- Department of Consultation-Liaison Psychiatry and Psychosomatic Medicine, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | | | - Monique C Pfaltz
- Department of Psychology and Social Work, Mid Sweden University, Östersund, Sweden
| | - Matthis Schick
- Department of Consultation-Liaison Psychiatry and Psychosomatic Medicine, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | | | - Soraya Seedat
- Department of Psychiatry, Faculty of Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Fatlinda Shatri
- Department of Consultation-Liaison Psychiatry and Psychosomatic Medicine, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Hao Fong Sit
- Department of Psychology, Faculty of Social Sciences, The University of Hong Kong, Hong Kong, People's Republic of China
| | - Roland von Känel
- Department of Consultation-Liaison Psychiatry and Psychosomatic Medicine, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Tobias R Spiller
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
- US Department of Veterans Affairs National Center for PTSD, VA Connecticut, Healthcare System, West Haven, CT, USA
- Department of Consultation-Liaison Psychiatry and Psychosomatic Medicine, University Hospital Zurich, University of Zurich, Zurich, Switzerland
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Valladares-Garrido MJ, Zapata-Castro LE, Peralta CI, García-Vicente A, Astudillo-Rueda D, León-Figueroa DA, Díaz-Vélez C. Post-Traumatic Stress Disorder after the 6.1 Magnitude Earthquake in Piura, Peru: A Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:11035. [PMID: 36078753 PMCID: PMC9518033 DOI: 10.3390/ijerph191711035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/25/2022] [Revised: 08/02/2022] [Accepted: 08/09/2022] [Indexed: 06/15/2023]
Abstract
In Peru, major disasters like the 2007 Pisco earthquake have produced high rates of post-traumatic stress. However, evidence is still needed to strengthen interventions. In 2021, a major earthquake struck Piura, in northern Peru. In this context, we aimed to assess the prevalence of PTSD and its associated factors. A cross-sectional study was conducted during August-September 2021 in people who experienced the 6.1 Piura earthquake on 30 July 2021. The questionnaire included the PCL-C, CD-RISC, ISI, HFIAS, and additional demographic data. Generalized linear models were used. The prevalence of PTSD was 20.3%. Household income was between PEN 2001 and 3000 (PR = 4.26, 95% CI: 1.08-16.75), smoking (PR = 2.49, 95% CI: 1.03-6.01), experience of a nervous breakdown (PR = 1.83, 95% CI: 1.09-3.09), moderate food insecurity (PR = 2.91, 95% CI: 1.10-7.73), and severe insomnia (PR = 8.25, 95% CI: 2.22-30.71) increased the prevalence of PTSD. One out of five individuals experienced post-traumatic stress symptoms after the 2021 earthquake in Piura, which varies depending on socioeconomic, psychosocial, and individual factors. Further research should strengthen these findings to ensure a fair and early mental health intervention against new seismic events in this and other Peruvian regions.
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Affiliation(s)
- Mario J. Valladares-Garrido
- South American Center for Education and Research in Public Health, Universidad Norbert Wiener, Lima 15046, Peru
- Hospital Regional Lambayeque, Chiclayo 14012, Peru
| | - Luis E. Zapata-Castro
- Faculty of Medicine, Universidad Nacional de Piura, Piura 20002, Peru
- Sociedad Científica de Estudiantes de Medicina de la Universidad Nacional de Piura (SOCIEMUNP), Piura 20002, Peru
| | - C. Ichiro Peralta
- Faculty of Medicine, Universidad Nacional Federico Villarreal, Lima 15088, Peru
| | - Abigaíl García-Vicente
- Faculty of Medicine, Universidad Nacional de Piura, Piura 20002, Peru
- Sociedad Científica de Estudiantes de Medicina de la Universidad Nacional de Piura (SOCIEMUNP), Piura 20002, Peru
| | | | - Darwin A. León-Figueroa
- Emerge, Emerging Diseases and Climate Change Research Unit, School of Public Health and Administration, Universidad Peruana Cayetano Heredia, Lima 15013, Peru
- Faculty of Medicine, Universidad de San Martín de Porres, Chiclayo 14012, Peru
| | - Cristian Díaz-Vélez
- School of Medicine, Universidad Privada Antenor Orrego, Trujillo 13008, Peru
- Instituto de Evaluación de Tecnologías en Salud e Investigación-IETSI, EsSalud, Lima 15072, Peru
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Andrews AR, Acosta LM, Acosta Canchila MN, Haws JK, Holland KJ, Holt NR, Ralston AL. Perceived Barriers and Preliminary PTSD Outcomes in an Open Pilot Trial of Written Exposure Therapy With Latinx Immigrants. COGNITIVE AND BEHAVIORAL PRACTICE 2022; 29:648-665. [PMID: 36171805 PMCID: PMC9512264 DOI: 10.1016/j.cbpra.2021.05.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Latinx immigrants experience substantial disparities in mental health treatment access, particularly for posttraumatic stress disorder (PTSD). The availability of brief, flexible interventions in Spanish may assist in reducing these disparities. Written Exposure Therapy (WET) is a five-session PTSD intervention that appears as effective as longer, gold-standard interventions, but has yet to be tested among Latinx immigrants. To test the acceptability and preliminary effectiveness of WET, 20 Spanish-speaking, Latinx immigrants conducted structured interviews at pretreatment, were offered WET, and completed posttreatment structured interviews. Open thematic coding of pre- and posttreatment interview questions examined perceived barriers and benefits of WET. Quantitative components examined symptom change across PTSD (PCL-IV-C) and depression (PHQ-9). Quantitative results indicated clinically meaningful and statistically significant change in PTSD symptoms using intent-to-treat analyses (Mdiff = 17.06, SDdiff = 9.97, range = 0-29, t(15) = 6.84, p < .001). Open thematic coding identified four barrier-related themes and three benefit-related themes at pretreatment. At posttreatment, three barrier-related themes and two benefit-related themes were identified. Qualitative results largely suggested that perceived barriers were common to other PTSD interventions (e.g., exposure components). Only one participant identified barriers specific to WET. Results suggested WET may reduce PTSD symptoms among Latinx immigrants. WET also appeared to be acceptable and primarily viewed as beneficial among this population. WET is a promising intervention with Latinx immigrants and warrants further testing larger trials, including testing implementation strategies that may improve access to care.
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Figueroa RA, Cortés PF, Marín H, Vergés A, Gillibrand R, Repetto P. The ABCDE psychological first aid intervention decreases early PTSD symptoms but does not prevent it: results of a randomized-controlled trial. Eur J Psychotraumatol 2022; 13:2031829. [PMID: 35251529 PMCID: PMC8890535 DOI: 10.1080/20008198.2022.2031829] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Revised: 12/20/2021] [Accepted: 01/16/2022] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Early Psychological First Aid (PFA) has been widely recommended for preventing posttraumatic stress disorder (PTSD). However, its lack of empirical evidence of safety and effectiveness has been criticized. OBJECTIVES To assess the effectiveness of PFA-ABCDE, an original PFA protocol, for preventing PTSD one month after the intervention and decreasing PTSD symptoms at one and six months of follow up. METHODS We assessed the eligibility of 1,140 adult survivors of recent trauma (≤ 72 hours) consulting five emergency departments in Chile. Two hundred twenty-one were randomized to receive either PFA-ABCDE (active listening, breathing retraining, categorization of needs, referral to ancillary services, and psychoeducation) or only psychoeducation. We used the Composite International Diagnostic Interview (CIDI) to assess PTSD diagnosis. The Posttraumatic Checklist (PCL), the Beck Depression Inventory-II (BDI-II), and a 0-10 points analogue visual scale were used to assess PTSD symptoms, depressive symptoms, and immediate distress relief after the intervention. RESULTS We found no difference between the experimental and control groups in the frequency of PTSD one month after the intervention (PFA-ABCDE = 23/76 [30.3%], psychoeducation = 18/75 [24.0%], adjusted odds ratio = 1.39, 95% confidence interval = 0.63-3.07, p = .408). Immediately after the intervention, participants who received PFA-ABCDE reported greater distress relief (PFA-ABCDE mean = 9.06, psychoeducation mean = 8.55, Cohen's d = 0.30, p = .038). Fewer PTSD symptoms were reported by those who received PFA-ABCDE one month after the intervention (PFA-ABCDE mean = 36.26, psychoeducation mean = 43.62, Cohen's d = 0.42, p = .033). We found no difference in depressive symptoms at one-month follow up (p = .713) nor in PTSD symptoms six months after the intervention (p = .986). CONCLUSIONS PFA-ABCDE does not prevent PTSD diagnosis, but it provides immediate distress relief and decreases PTSD symptoms in the short term.
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Affiliation(s)
- Rodrigo Andrés Figueroa
- Trauma & Dissociation Unit, Department of Psychiatry, School of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
- Research Center for Integrated Natural Disaster Management (Cigiden), Santiago, Chile, CONICYT/FONDAP/1511007
| | - Paula Francisca Cortés
- Research Center for Integrated Natural Disaster Management (Cigiden), Santiago, Chile, CONICYT/FONDAP/1511007
| | - Humberto Marín
- Research Center for Integrated Natural Disaster Management (Cigiden), Santiago, Chile, CONICYT/FONDAP/1511007
| | - Alvaro Vergés
- Research Center for Integrated Natural Disaster Management (Cigiden), Santiago, Chile, CONICYT/FONDAP/1511007
- Escuela de Psicología, Pontificia Universidad Católica de Chile, Macul, Chile
| | - Rodrigo Gillibrand
- Hospital Del Trabajador, Asociación Chilena de Seguridad, Providencia, Chile
| | - Paula Repetto
- Research Center for Integrated Natural Disaster Management (Cigiden), Santiago, Chile, CONICYT/FONDAP/1511007
- Escuela de Psicología, Pontificia Universidad Católica de Chile, Macul, Chile
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10
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Orovou E, Theodoropoulou IM, Antoniou E. Psychometric properties of the Post Traumatic Stress Disorder Checklist for DSM-5 (PCL-5) in Greek women after cesarean section. PLoS One 2021; 16:e0255689. [PMID: 34388199 PMCID: PMC8363016 DOI: 10.1371/journal.pone.0255689] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Accepted: 07/21/2021] [Indexed: 11/22/2022] Open
Abstract
The aim of this study was to examine psychometric properties of the revised Posttraumatic Stress Checklist (PCL-5) for Diagnostic and Statistical Manual- 5th Edition (DSM-5) in Greek postpartum women after Cesarean Section(CS) (emergency-elective).So far, there was no study in Greece assessing psychometric properties of the PCL-5 in women after CS. The participating women (N = 469), who gave birth with emergency and elective CS at the Greek University Hospital of Larisa, have consented to participate in two phases of the survey and completed self-report questionnaires, the 2nd day after CS and at the 6th week after CS. Measures used in this study were the PCL-5 for DSM-5, the Life Events Checklist (LEC-5), Criteria B, C, D, E, and Criterion A, specifically designed for detection of posttraumatic stress disorder (PTSD) symptoms in postpartum period. To evaluate the internal reliability of the PCL-5 two different indices of internal consistency were calculated, i.e., Cronbach's alpha (.97) and Guttman'ssplit-half (.95), demonstrating high reliability level. The data were positively skewed, suggesting that the reported levels of PTSD among our participants were low. Factor analyses demonstrated acceptable construct validity; a comparison of thePCL-5 with the other measures of the same concept showed a good convergent validity of the scale. Overall, all the results suggest that the four-factor PCL-5 seemed to work adequately for the Greek sample of women after CS.
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Affiliation(s)
- Eirini Orovou
- Department of Midwifery, University of West Attica, Aigaleo, Greece
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11
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Li X, Lv Q, Tang W, Deng W, Zhao L, Meng Y, Guo W, Li T. Psychological stresses among Chinese university students during the COVID-19 epidemic: The effect of early life adversity on emotional distress. J Affect Disord 2021; 282:33-38. [PMID: 33387744 PMCID: PMC7985596 DOI: 10.1016/j.jad.2020.12.126] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2020] [Accepted: 12/24/2020] [Indexed: 02/08/2023]
Abstract
BACKGROUND Coronavirus disease 2019 (COVID-19) is leading to numerous psychological outcomes, especially emotional distress. Individuals with early life adversity (ELA) may be more susceptible to those psychological stresses during this epidemic. AIMS To measure the effect of the ELA on acute stress reactions, anxiety and depression during the COVID-19 epidemic, and to examine whether specific trauma types and frequencies of exposure are associated with a more severe acute stress reaction and increased risk of anxiety and depressive symptoms. METHOD This investigation was performed at college students in a comprehensive University of China. The online self-report questionnaire included ELA experiences, exposure to epidemic-related events, acute stress reactions, and anxiety and depression symptoms during the COVID-19 epidemic. Logistic regression and stepwise regression were used to assess the associations and interactions among these variables. RESULTS Participants with ELA reported more exposure to epidemic-related events and more severe stress reactions during the epidemics than did those with no ELA. The experience of ELA is associated with acute stress reactions, anxiety and depression in early adulthood. Furthermore, experiencing more ELA during childhood may not only increase the risk of anxiety and depression episode in early adulthood but also lead to more severe acute stress reactions during the epidemic. CONCLUSION Regardless of specific ELA types, ELAs have longer time effects on individual's susceptibility to stress. Under this epidemic, the mental health in young adults with ELA needs more attention.
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Affiliation(s)
- Xiaojing Li
- Mental Health Center and Psychiatric Laboratory, West China Hospital of Sichuan University, Chengdu, Sichuan, China,Brain Research Center, West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | - Qiuyue Lv
- Mental Health Center and Psychiatric Laboratory, West China Hospital of Sichuan University, Chengdu, Sichuan, China,Brain Research Center, West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | - Wanjie Tang
- Mental Health Education Center, Sichuan University, Chengdu, Sichuan, China
| | - Wei Deng
- Mental Health Center and Psychiatric Laboratory, West China Hospital of Sichuan University, Chengdu, Sichuan, China,Brain Research Center, West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | - Liansheng Zhao
- Mental Health Center and Psychiatric Laboratory, West China Hospital of Sichuan University, Chengdu, Sichuan, China,Brain Research Center, West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | - Yajing Meng
- Mental Health Center and Psychiatric Laboratory, West China Hospital of Sichuan University, Chengdu, Sichuan, China,Brain Research Center, West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | - Wanjun Guo
- Mental Health Center and Psychiatric Laboratory, West China Hospital of Sichuan University, Chengdu, Sichuan, China,Brain Research Center, West China Hospital of Sichuan University, Chengdu, Sichuan, China
| | - Tao Li
- Mental Health Center and Psychiatric Laboratory, West China Hospital of Sichuan University, Chengdu, Sichuan, China; Brain Research Center, West China Hospital of Sichuan University, Chengdu, Sichuan, China; Mental Health Education Center, Sichuan University, Chengdu, Sichuan, China; Guangdong-Hong Kong-Macao Greater Bay Area Center for Brain Science and Brain-Inspired Intelligence, Guangzhou, China.
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12
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Gallagher MW, Long LJ, Phillips CA. Hope, optimism, self‐efficacy, and posttraumatic stress disorder: A meta‐analytic review of the protective effects of positive expectancies. J Clin Psychol 2019; 76:329-355. [DOI: 10.1002/jclp.22882] [Citation(s) in RCA: 56] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Affiliation(s)
- Matthew W. Gallagher
- Department of Psychology, Texas Institute for Measurement, Evaluation, and StatisticsUniversity of HoustonHouston Texas
| | - Laura J. Long
- Department of Psychology, Texas Institute for Measurement, Evaluation, and StatisticsUniversity of HoustonHouston Texas
| | - Colleen A. Phillips
- Department of Psychology, Texas Institute for Measurement, Evaluation, and StatisticsUniversity of HoustonHouston Texas
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13
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Hall BJ, Yip PSY, Garabiles MR, Lao CK, Chan EWW, Marx BP. Psychometric validation of the PTSD Checklist-5 among female Filipino migrant workers. Eur J Psychotraumatol 2019; 10:1571378. [PMID: 30774783 PMCID: PMC6366408 DOI: 10.1080/20008198.2019.1571378] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2018] [Revised: 12/20/2018] [Accepted: 01/04/2019] [Indexed: 01/08/2023] Open
Abstract
Migrant populations are at increased risk for exposure to traumatic life events. Presently, there are no reliable and valid screening instruments for posttraumatic stress disorder (PTSD) among Filipino migrant workers, a population that numbers over 2.3 million worldwide. This study evaluated the psychometric properties of the PTSD Checklist for DSM-5 (PCL-5) in a sample of female Filipino migrant workers in Macao (SAR), China, in two studies. The first examined the reliability (internal and test-retest), convergent validity (with depression, anxiety, and rumination), and discriminant validity (with pain and social support) in a sample of 131 participants. The second study established criterion validity of the PCL-5 using the PTSD module of the Mini-International Neuropsychiatric Interview (MINI), delivered by a female Filipino psychologist as the criterion, in a sample of 100 participants. Results indicated excellent internal consistency (Cronbach's alpha = 0.95) and moderate 10-day test-retest reliability (ρ = 0.58, p < .001). PCL-5 scores correlated strongly with scores on measures of depression (ρ = 0.71, p < .001), anxiety (ρ = 0.61, p < .001), and rumination (ρ = 0.68, p < .001), supporting convergent validity. Discriminant validity was demonstrated by a weaker association with scores on measures of pain (ρ = 0.33, p < .001) and social support (ρ = -0.11, p = .22). The diagnostic accuracy of the scale was good (AUC = 0.87). The optimal cutoff score of 25 optimized sensitivity (0.89) while maintaining adequate specificity (0.73), with a weighted Kappa of κ[1]) = 0.82. Our results demonstrated that the PCL-5 is a reliable and valid screening instrument for use among female Filipino migrant workers.
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Affiliation(s)
- Brian J. Hall
- Global and Community Mental Health Research Group, Faculty of Social Sciences, The University of Macau, Macau (SAR), People’s Republic of China
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Paul S. Y. Yip
- Global and Community Mental Health Research Group, Faculty of Social Sciences, The University of Macau, Macau (SAR), People’s Republic of China
| | - Melissa R. Garabiles
- Global and Community Mental Health Research Group, Faculty of Social Sciences, The University of Macau, Macau (SAR), People’s Republic of China
- Department of Psychology, Ateneo de Manila University, Quezon City, Philippines
| | - Chao Kei Lao
- Global and Community Mental Health Research Group, Faculty of Social Sciences, The University of Macau, Macau (SAR), People’s Republic of China
| | - Edward W. W. Chan
- Global and Community Mental Health Research Group, Faculty of Social Sciences, The University of Macau, Macau (SAR), People’s Republic of China
| | - Brian P. Marx
- Department of Veteran Affairs, National Center for PTSD, Boston, USA
- Department of Psychiatry, Boston University, Boston, USA
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Zeng B, Zhao J, Zou L, Yang X, Zhang X, Wang W, Zhao J, Chen J. Depressive symptoms, post-traumatic stress symptoms and suicide risk among graduate students: The mediating influence of emotional regulatory self-efficacy. Psychiatry Res 2018; 264:224-230. [PMID: 29655115 DOI: 10.1016/j.psychres.2018.03.022] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2017] [Revised: 03/07/2018] [Accepted: 03/07/2018] [Indexed: 10/17/2022]
Abstract
The current study was to examine the relationship among depressive symptoms, post-traumatic stress symptoms, emotion regulatory self-efficacy and suicide risk. A cross-sectional survey was conducted among 3257 graduate students from a medical college of China. Lifetime prevalence of suicidal ideation, plan and attempt were 25.7%, 1.6%, 1.1%, respectively, with one-year suicidal ideation showing at 6.3%. Structural equation modeling was employed to examine the relative contribution of depressive symptoms, post-traumatic stress symptoms and emotion regulatory self-efficacy on suicide risk. Structural equation model had a highly satisfactory fit [χ2 = 7.782, df = 4, p = 0.096; RMSEA = 0.021; CFI = 0.992; GFI = 0.997]. Post-traumatic stress symptoms had a direct effect and an indirect effect on suicide risk via emotion regulatory self-efficacy. Depressive symptoms also had a direct effect and an indirect effect on suicide risk via emotion regulatory self-efficacy. The depressive and post-traumatic stress symptoms increased the risk of suicide risk, but the variable of emotion regulatory self-efficacy would be served as a buffering factor, decreasing the risk of suicide. The interaction term of depressive symptoms and post-traumatic stress symptoms had a direct effect on suicide risk. A significant interactive effect of depressive and post-traumatic stress symptoms on suicide risk was found.
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Affiliation(s)
- Baoer Zeng
- Department of Psychology, School of Public Health, Southern Medical University, Guangzhou, China
| | - Jiubo Zhao
- Department of Psychology, School of Public Health, Southern Medical University, Guangzhou, China.
| | - Laiquan Zou
- Department of Psychology, School of Public Health, Southern Medical University, Guangzhou, China
| | - Xueling Yang
- Department of Psychology, School of Public Health, Southern Medical University, Guangzhou, China
| | - Xiaoyuan Zhang
- Department of Psychology, School of Public Health, Southern Medical University, Guangzhou, China
| | - Wanjun Wang
- Department of Graduate Student, Southern Medical University, Guangzhou, China
| | - Jingbo Zhao
- Department of Psychology, School of Public Health, Southern Medical University, Guangzhou, China
| | - Jie Chen
- Department of Psychology, School of Public Health, Southern Medical University, Guangzhou, China
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15
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Verhey R, Chibanda D, Gibson L, Brakarsh J, Seedat S. Validation of the posttraumatic stress disorder checklist - 5 (PCL-5) in a primary care population with high HIV prevalence in Zimbabwe. BMC Psychiatry 2018; 18:109. [PMID: 29685117 PMCID: PMC5913864 DOI: 10.1186/s12888-018-1688-9] [Citation(s) in RCA: 52] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2017] [Accepted: 04/16/2018] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND There is a dearth of validated tools measuring posttraumatic stress disorder (PTSD) in low and middle-income countries in sub-Saharan Africa. We validated the Shona version of the PTSD Checklist for DSM-5 (PCL-5) in a primary health care clinic in Harare, Zimbabwe. METHOD Adults aged 18 and above attending the clinic were enrolled over a two-week period in June 2016. After obtaining written consent, trained research assistants administered the tool to eligible participants. Study participants were then interviewed independently using the Clinician Administered PTSD Scale (CAPS-5) as the gold standard by one of five doctors with training in mental health. RESULT A total of 204 participants were assessed. Of these, 91 (44.6%) were HIV positive, 100 (49%) were HIV negative, while 13 (6.4%) did not know their HIV status. PTSD was diagnosed in 40 (19.6%) participants using the gold standard procedure. Using the PCL-5 cut-off of ≥33, sensitivity and specificity were 74.5% (95%CI: 60.4-85.7); 70.6% (95%CI: 62.7-77.7), respectively. The area under the ROC curve was 0.78 (95%CI: 0.72-0.83). The Shona version of the PCL-5 demonstrated good internal consistency (Cronbach's alpha = 0.92). CONCLUSION The PCL-5 performed well in this population with a high prevalence of HIV. There is need to explore ways of integrating screening tools for PTSD in interventions delivered by lay health workers in low and middle-income countries (LMIC).
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Affiliation(s)
- Ruth Verhey
- Zimbabwe Aids Prevention Project, 92 Prince Edward Road, Milton Park, Harare, Zimbabwe.
| | | | - Lorna Gibson
- London School of Tropical Medicine and Hygiene, London, UK
| | | | - Soraya Seedat
- 0000 0001 2214 904Xgrid.11956.3aCollege of Health Sciences, Stellenbosch University, Stellenbosch, South Africa
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Fernandez CA, Vicente B, Marshall BD, Koenen KC, Arheart KL, Kohn R, Saldivia S, Buka SL. Longitudinal course of disaster-related PTSD among a prospective sample of adult Chilean natural disaster survivors. Int J Epidemiol 2018; 46:440-452. [PMID: 27283159 DOI: 10.1093/ije/dyw094] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/31/2016] [Indexed: 11/14/2022] Open
Abstract
Background With an increasing number of individuals surviving natural disasters, it is crucial to understand who is most at risk for developing post-traumatic stress disorder (PTSD). The objective of this study was to prospectively examine the role that pre-existing psychopathology plays in developing PTSD after a disaster. Methods This study uses data from a prospective 5-wave longitudinal cohort (years 2003-11) of Chilean adults from 10 health centres ( N = 1708). At baseline, participants completed the Composite International Diagnostic Interview (CIDI), a comprehensive psychiatric diagnostic instrument. In 2010, the sixth most powerful earthquake on record struck Chile. One year later, a modified version of the PTSD module of the CIDI was administered. Marginal structural logistic regressions with inverse probability censoring weights were constructed to identify pre-disaster psychiatric predictors of post-disaster PTSD. Results The majority of participants were female (75.9%) and had a high-school/college education (66.9%). After controlling for pre-disaster PTSD, pre-existing dysthymia [odds ratio (OR) = 2.21; 95% confidence interval (CI) = 1.39-3.52], brief psychotic disorder (OR = 2.67; 95% CI = 1.21-5.90), anxiety disorders (not including PTSD; OR = 1.49; 95% CI = 1.27-1.76), panic disorder (OR = 2.46; 95% CI = 1.37-4.42), agoraphobia (OR = 2.23; 95% CI = 1.22-4.10), social phobia (OR = 1.86; 95% CI = 1.06-3.29), specific phobia (OR = 2.07; 95% CI = 1.50-2.86) and hypochondriasis (OR = 2.10; 95% CI = 1.05-4.18) were predictors of post-disaster PTSD. After controlling for pre-disaster anxiety disorders, dysthymia, and non-affective psychotic disorders, individuals with pre-disaster PTSD (vs those without pre-disaster PTSD) had higher odds of developing post-disaster PTSD (OR = 2.53; 95% CI = 1.37-4.65). Conclusions This is the first Chilean study to demonstrate prospectively that pre-disaster psychiatric disorders, independent of a prior history of other psychiatric disorders, increase the vulnerability to develop PTSD following a major natural disaster.
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Affiliation(s)
- Cristina A Fernandez
- Department of Epidemiology, School of Public Health, Brown University, Providence, RI, USA
| | - Benjamin Vicente
- Departamento de Psiquiatría y Salud Mental, Universidad de Concepción, Concepción, Chile
| | - Brandon Dl Marshall
- Department of Epidemiology, School of Public Health, Brown University, Providence, RI, USA
| | - Karestan C Koenen
- Department of Epidemiology, T.H. Chan School of Public Health, Harvard University, Boston, MA, USA
| | - Kristopher L Arheart
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Robert Kohn
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School, Brown University, Providence, RI, USA
| | - Sandra Saldivia
- Departamento de Psiquiatría y Salud Mental, Universidad de Concepción, Concepción, Chile
| | - Stephen L Buka
- Department of Epidemiology, School of Public Health, Brown University, Providence, RI, USA
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Reichenheim ME, Oliveira AG, Moraes CL, Coutinho ES, Figueira I, Lobato G. Reappraising the dimensional structure of the PTSD Checklist: lessons from the DSM-IV-based PCL-C. ACTA ACUST UNITED AC 2017; 40:154–162. [PMID: 29069251 PMCID: PMC6900771 DOI: 10.1590/1516-4446-2017-2239] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2017] [Accepted: 05/24/2017] [Indexed: 11/22/2022]
Abstract
OBJECTIVE The dimensional structure of posttraumatic stress disorder (PTSD) has been extensively debated, but the literature is still inconclusive and contains gaps that require attention. This article sheds light on hitherto unvisited methodological issues, reappraising several key models advanced for the DSM-IV-based civilian version of the PTSD Checklist (PCL-C) as to their configural and metric structures. METHODS The sample comprised 456 women, interviewed at 6-8 weeks postpartum, who attended a high-complexity facility in Rio de Janeiro, Brazil. Confirmatory factor analysis (CFA) and exploratory structural equation models (ESEM) were used to evaluate the dimensional structure of the PCL-C. RESULTS The original three-factor solution was rejected, along with the four-factor structures most widely endorsed in the literature (PTSD-dysphoria and PTSD-numbing models). Further exploration supported a model comprised of two factors (re-experience/avoidance and numbing/hyperarousal). CONCLUSION These findings are at odds with the dimensional structure proposed in both DSM-IV and DSM-5. This also entails a different presumption regarding the latent structure of PTSD and how the PCL should be operationalized.
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Affiliation(s)
- Michael E Reichenheim
- Departamento de Epidemiologia, Instituto de Medicina Social, Universidade do Estado do Rio de Janeiro (UERJ), Rio de Janeiro, RJ, Brazil
| | - Aline G Oliveira
- Departamento de Epidemiologia, Instituto de Medicina Social, Universidade do Estado do Rio de Janeiro (UERJ), Rio de Janeiro, RJ, Brazil
| | - Claudia L Moraes
- Departamento de Epidemiologia, Instituto de Medicina Social, Universidade do Estado do Rio de Janeiro (UERJ), Rio de Janeiro, RJ, Brazil.,Programa de Mestrado em Saúde da Família, Universidade Estácio de Sá, Rio de Janeiro, RJ, Brazil
| | - Evandro S Coutinho
- Departamento de Epidemiologia, Instituto de Medicina Social, Universidade do Estado do Rio de Janeiro (UERJ), Rio de Janeiro, RJ, Brazil.,Departamento de Epidemiologia, Escola Nacional de Saúde Pública, Fundação Oswaldo Cruz (Fiocruz), Rio de Janeiro, RJ, Brazil
| | - Ivan Figueira
- Instituto de Psiquiatria, Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, RJ, Brazil
| | - Gustavo Lobato
- Instituto Fernandes Figueira, Fiocruz, Rio de Janeiro, RJ, Brazil
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Gelaye B, Zheng Y, Medina-Mora ME, Rondon MB, Sánchez SE, Williams MA. Validity of the posttraumatic stress disorders (PTSD) checklist in pregnant women. BMC Psychiatry 2017; 17:179. [PMID: 28494804 PMCID: PMC5427611 DOI: 10.1186/s12888-017-1304-4] [Citation(s) in RCA: 54] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2016] [Accepted: 04/04/2017] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND The PTSD Checklist-civilian (PCL-C) is one of the most commonly used self-report measures of PTSD symptoms, however, little is known about its validity when used in pregnancy. This study aims to evaluate the reliability and validity of the PCL-C as a screen for detecting PTSD symptoms among pregnant women. METHODS A total of 3372 pregnant women who attended their first prenatal care visit in Lima, Peru participated in the study. We assessed the reliability of the PCL-C items using Cronbach's alpha. Criterion validity and performance characteristics of PCL-C were assessed against an independent, blinded Clinician-Administered PTSD Scale (CAPS) interview using measures of sensitivity, specificity and receiver operating characteristics (ROC) curves. We tested construct validity using exploratory and confirmatory factor analytic approaches. RESULTS The reliability of the PCL-C was excellent (Cronbach's alpha =0.90). ROC analysis showed that a cut-off score of 26 offered optimal discriminatory power, with a sensitivity of 0.86 (95% CI: 0.78-0.92) and a specificity of 0.63 (95% CI: 0.62-0.65). The area under the ROC curve was 0.75 (95% CI: 0.71-0.78). A three-factor solution was extracted using exploratory factor analysis and was further complemented with three other models using confirmatory factor analysis (CFA). In a CFA, a three-factor model based on DSM-IV symptom structure had reasonable fit statistics with comparative fit index of 0.86 and root mean square error of approximation of 0.09. CONCLUSION The Spanish-language version of the PCL-C may be used as a screening tool for pregnant women. The PCL-C has good reliability, criterion validity and factorial validity. The optimal cut-off score obtained by maximizing the sensitivity and specificity should be considered cautiously; women who screened positive may require further investigation to confirm PTSD diagnosis.
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Affiliation(s)
- Bizu Gelaye
- Department of Epidemiology, Harvard T. H. Chan School of Public Health, 677 Huntington Ave, K505F, Boston, MA, 02115, USA.
| | - Yinnan Zheng
- 000000041936754Xgrid.38142.3cDepartment of Epidemiology, Harvard T. H. Chan School of Public Health, 677 Huntington Ave, K505F, Boston, MA 02115 USA
| | | | - Marta B. Rondon
- 0000 0001 0673 9488grid.11100.31Department of Medicine, Cayetano Heredia Peruvian University, Lima, Peru
| | - Sixto E. Sánchez
- grid.441917.eUniversidad Peruana de Ciencias Aplicadas, Lima, Peru ,Asociación Civil PROESA, Lima, Peru
| | - Michelle A. Williams
- 000000041936754Xgrid.38142.3cDepartment of Epidemiology, Harvard T. H. Chan School of Public Health, 677 Huntington Ave, K505F, Boston, MA 02115 USA
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Gustems-Carnicer J, Calderón C, Forn Santacana M. Psychometric properties of the Life Orientation Test (LOT-R) and its relationship with psychological well-being and academic progress in college students. REVISTA LATINOAMERICANA DE PSICOLOGIA 2017. [DOI: 10.1016/j.rlp.2016.05.001] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Fodor KE, Pozen J, Ntaganira J, Sezibera V, Neugebauer R. The factor structure of posttraumatic stress disorder symptoms among Rwandans exposed to the 1994 genocide: A confirmatory factor analytic study using the PCL-C. J Anxiety Disord 2015; 32:8-16. [PMID: 25840139 DOI: 10.1016/j.janxdis.2015.03.001] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2014] [Revised: 03/01/2015] [Accepted: 03/03/2015] [Indexed: 11/19/2022]
Abstract
The factor structure of posttraumatic stress disorder (PTSD) symptoms in Euro-American populations has been extensively studied, but confirmatory factor analytic studies from non-Western societies are lacking. Alternative models of DSM-IV symptoms were tested among Rwandan adults (N=465) who experienced trauma during the 1994 genocide. A cluster random survey was conducted with interviews held in Rwandan households. PTSD was assessed with the Posttraumatic Stress Disorder Checklist-Civilian version. Competing models were the DSM-IV, emotional numbing, dysphoria, aroused intrusion, and dysphoric arousal models. Results showed that the emotional numbing, dysphoria, and dysphoric arousal models had almost identical, good fit indices and fit the data significantly better than the other models. The emotional numbing and dysphoric arousal models also exhibited good construct validity. Results suggest that the latent structure of PTSD symptoms in Rwanda are comparable to that found in Euro-American samples, thereby lending further support to the cross-cultural validity of the construct.
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Affiliation(s)
- Kinga E Fodor
- Semmelweis University, Faculty of Medicine, Department of Psychiatry and Psychotherapy, Balassa utca 6,Budapest 1083, Hungary.
| | - Joanna Pozen
- Columbia University Medical Center, Department of Psychiatry, 180 Ft. Washington Avenue, New York, NY 10032, USA.
| | - Joseph Ntaganira
- National University of Rwanda, School of Public Health, Departments of Epidemiology and Biostatistics, PO Box 5229, Kigali, Rwanda.
| | - Vincent Sezibera
- University of Rwanda, School of Medicine and Pharmacy, Department of Clinical Psychology, PO Box 3286, Kigali, Rwanda.
| | - Richard Neugebauer
- Columbia University Medical Center, Department of Psychiatry, 180 Ft. Washington Avenue, New York, NY 10032, USA; Division of Epidemiology, New York State Psychiatric Institute, New York, NY; Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY.
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Stammel N, Abbing EM, Heeke C, Knaevelsrud C. Applicability of the ICD-11 proposal for PTSD: a comparison of prevalence and comorbidity rates with the DSM-IV PTSD classification in two post-conflict samples. Eur J Psychotraumatol 2015; 6:27070. [PMID: 25989951 PMCID: PMC4438098 DOI: 10.3402/ejpt.v6.27070] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2014] [Revised: 04/07/2015] [Accepted: 04/08/2015] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND The World Health Organization recently proposed significant changes to the posttraumatic stress disorder (PTSD) diagnostic criteria in the 11th edition of the International Classification of Diseases (ICD-11). OBJECTIVE The present study investigated the impact of these changes in two different post-conflict samples. METHOD Prevalence and rates of concurrent depression and anxiety, socio-demographic characteristics, and indicators of clinical severity according to ICD-11 in 1,075 Cambodian and 453 Colombian civilians exposed to civil war and genocide were compared to those according to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV). RESULTS Results indicated significantly lower prevalence rates under the ICD-11 proposal (8.1% Cambodian sample and 44.4% Colombian sample) compared to the DSM-IV (11.2% Cambodian sample and 55.0% Colombian sample). Participants meeting a PTSD diagnosis only under the ICD-11 proposal had significantly lower rates of concurrent depression and a lower concurrent total score (depression and anxiety) compared to participants meeting only DSM-IV diagnostic criteria. There were no significant differences in socio-demographic characteristics and indicators of clinical severity between these two groups. CONCLUSIONS The lower prevalence of PTSD according to the ICD-11 proposal in our samples of persons exposed to a high number of traumatic events may counter criticism of previous PTSD classifications to overuse the PTSD diagnosis in populations exposed to extreme stressors. Also another goal, to better distinguish PTSD from comorbid disorders could be supported with our data.
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Affiliation(s)
- Nadine Stammel
- Department of Clinical Psychology and Psychotherapy, Freie Universität Berlin, Berlin, Germany.,Center for Torture Victims, Berlin, Germany;
| | - Eva M Abbing
- Department of Clinical Psychology and Psychotherapy, Freie Universität Berlin, Berlin, Germany
| | - Carina Heeke
- Department of Clinical Psychology and Psychotherapy, Freie Universität Berlin, Berlin, Germany.,Center for Torture Victims, Berlin, Germany
| | - Christine Knaevelsrud
- Department of Clinical Psychology and Psychotherapy, Freie Universität Berlin, Berlin, Germany.,Center for Torture Victims, Berlin, Germany
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Social capital and chronic post-traumatic stress disorder among survivors of the 2007 earthquake in Pisco, Peru. Soc Sci Med 2013; 101:9-17. [PMID: 24560219 DOI: 10.1016/j.socscimed.2013.11.012] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2013] [Revised: 10/16/2013] [Accepted: 11/01/2013] [Indexed: 11/22/2022]
Abstract
This study aimed to evaluate the association between chronic Post-Traumatic Stress Disorder (PTSD) and both structural and cognitive social capital in adult survivors of the 2007 earthquake in Pisco, Peru. Cognitive social capital measures trust, sense of belonging and interpersonal relationships in the community and structural social capital measures group membership, support from community groups and individuals, and involvement in citizenship activities. We conducted a population-based cross-sectional study in five counties in Pisco, selecting 1012 adults through complex, multi-stage random sampling. All participants completed socio-demographic questions and validated Spanish-language versions of the Adapted Social Capital Assessment Tool (SASCAT) and the civilian PTSD checklist (PCL-C). After performing descriptive and bivariate analyses, we carried out prevalence ratio (PR) regression. The overall prevalence of chronic PTSD was 15.9% (95% CI: 12.3, 19.8), much higher than anticipated based on existing evidence. Cognitive social capital was found to be negatively associated with chronic PTSD, while no significant association was found for structural social capital. Specifically, those with high cognitive social capital had an almost two times lower prevalence of chronic PTSD (PR = 1.83, 95% CI: 1.50, 2.22) compared with those with low cognitive social capital. No independent association between structural social capital and chronic PTSD was found (PR = 1.44, 95% CI: 0.70, 2.97). In conclusion, cognitive social capital, but not structural social capital, has a protective influence on the occurrence of chronic PTSD in survivors of natural disasters. These results may have public health implications. For example, pre- and post-disaster community-based interventions that catalyze and foster dimensions of cognitive social capital may aid in ameliorating the effect of earthquakes and other natural disasters on populations with high vulnerability to such events and poor access to mental health and other support services.
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