Coexistence and different determinants of posttraumatic stress disorder and posttraumatic growth among Chinese survivors after earthquake: role of resilience and rumination

Moderating effect of work fatigue on the association between resilience and posttraumatic stress symptoms: a cross-sectional multi-country study among pharmacists during the COVID-19 pandemic

INTRODUCTION

In the context of the COVID-19 pandemic, pharmacists, despite their vital contributions, have faced significant challenges that have impacted their mental well-being, potentially leading to the development of Post-Traumatic Stress symptoms (PTSS). The aim of this study was to investigate the role of work-related fatigue as a potential moderator in the relationship between pharmacists' resilience and their likelihood of experiencing PTSS during the COVID-19 pandemic.

METHODS

A cross-sectional survey was conducted online in eight countries from January to December 2021, including Brazil, Lebanon, Nigeria, Pakistan, Poland, Serbia, and Tunisia. The mediation analysis was conducted using PROCESS MACRO (an SPSS add-on) v3.4 model 1, taking work fatigue as a moderator in the association between resilience and PTSS.

RESULTS

A total of 442 pharmacists were enrolled in this study (mean age = 33.91 ± 10.36 years) with 59.5% of them being females. The results were adjusted over country, gender, working in contact with COVID-19, working patients, working mandatory hours, working voluntary hours, age, household crowding index and number of months engaged in COVID-19. The interactions resilience by physical (Beta = 0.02; p = .029), mental (Beta = 0.02; p = .040) and emotional (Beta = 0.03; p = .008) work fatigue were significantly associated with PTSS; for pharmacists with low to moderate levels of physical (Beta = - 0.33; p < .001 and Beta = - 0.21; p = .001), mental (Beta = - 0.29; p < .001 and Beta = - 0.18; p = .006) and emotional (Beta = - 0.31; p < .001 and Beta = - 0.17; p = .008) work fatigue, higher resilience was significantly related to lower PTSS levels. However, for pharmacists with high levels of physical/mental/emotional work fatigue, the association between resilience and PTSS became non-significant.

CONCLUSION

This study highlights the complex relationship between work-related fatigue, resilience, and PTSS in pharmacists. It emphasizes the need to address work-related fatigue for pharmacists' psychological well-being during crises, offering insights for tailored support and interventions.

Contribution of rumination and psychological resilience to post-traumatic growth of front-line healthcare workers in mobile cabin hospitals under Normalized epidemic Prevention and Control Requirements

To understand the level of post-traumatic growth (PTG) and influencing factors among front-line healthcare workers (HCWs) working in mobile cabin hospitals treating patients with Coronavirus Disease 2019 (COVID-19) under the Normalized Epidemic Prevention and Control Requirements adopted in China. A random sampling method was used to select 540 HCWs of the Chongqing-aid-Shanghai medical team from April to May 2022 as the study participants. Participants completed a general information questionnaire, the Post-traumatic Growth Inventory-Chinese version (PTGI-C), the Chinese version of the Connor-Davidson Resilience Scale (CD-RISC) and the Chinese Event Related Rumination Inventory (C-ERRI). Among the 540 included HCWs, 83.15 % were nurses and 78.89 % were women. The average scores for PTG (62.25 ± 16.73) and psychological resilience (64.22 ± 15.38) were at moderate levels, and the average score for rumination was low (21.62 ± 10.77). Pearson correlation analysis showed that CD-RISC and C-ERRI scores were positive with the PTGI-C score (r = 0.528, 0.316, P < 0.001). Multiple linear regression analysis identified psychological training or intervention during the COVID-19 epidemic (β = 2.353, P = 0.044), psychological resilience (β = 0.525, P < 0.001) and deliberate rumination (β = 0.732, P < 0.001) as factors significantly associated with the PTG of front-line HCWs, which together explained 36.8 % of the total variance in PTG (F[5,539] = 63.866, P < 0.001). In general, psychological resilience and deliberate rumination can promote PTG among HCWs and can be improved by strengthening psychological training and interventions for HCWs working under the Normalized Epidemic Prevention and Control Requirements.

Trait rumination in post-stress growth among Chinese college students: the chain mediating effect of distress disclosure and perceived social support

Background

Rumination has emerged as a significant factor contributing to personal growth following periods of stress or trauma. The present study aimed to investigate the relationship between trait rumination and post-stress growth (PSG) within the context of Chinese college students who encounter mild stressors in their daily lives. Moreover, we aim to evaluate the potential mediating roles played by both distress disclosure and perceived social support in this dynamic relationship.

Method

All participants completed assessments using the Adolescent Self-Rating Life Events Checklist, Rumination Response Scale, Post-Stress Growth Inventory, Distress Disclosure Index, and Perceived Social Support Scale. Correlation and mediation analyses were conducted using SPSS PROCESS 4 MACRO.

Results

All students reported experiencing mild psychological impacts as a result of negative life events in the past year and displayed moderate levels of PSG. There was no significant correlation observed between the effects of negative life events and PSG. Significant negative correlations were found between trait rumination and distress disclosure, perceived social support, and PSG. Distress disclosure and perceived social support jointly operated as sequential mediators in the relationship between trait rumination and PSG among all the participants. Qualitative analyses revealed different correlation patterns of high- versus low-ruminator.

Conclusion

Trait rumination affects PSG both directly and indirectly, through its influence on distress disclosure and perceived social support. Our results emphasize the significance of actively participating in distress disclosure and nurturing a robust sense of social support to counteract the detrimental effects of rumination on post-stress growth among Chinese college students.

Physicians' Resilience as a Positive Effect of COVID-19

People devoid of COVID-19 may exhibit mental health problems, such as anxiety disorders, depression, panic attack, insomnia, emotional disorder, and suicidal actions. Healthcare workers (HCWs) may also exhibit these problems. Physicians should be careful an "at-risk" population. Physicians revealed higher levels of resilience than the popular workers. Humans with stronger resilience have lower feeling of anxiety and depression. We investigated the risk to physicians from an infected environment to infected patients during the pandemic. The social and psychological support of all HCWs, particularly physicians, is significant in the fight against this pandemic. Physicians working with patients with COVID-19 should set enough time to relax, sleep, and spend time with family. Resilience in physicians facing COVID-19 can induce post-traumatic growth in the future.

[A Structural Equation Model for Posttraumatic Growth among Cured Patients with COVID-19]

PURPOSE

This study aimed to develop and test a model for posttraumatic growth among cured patients with COVID-19. This model was based on Calhoun and Tedeschi's Posttraumatic Growth model and a literature review.

METHODS

The participants comprised 223 patients cured from COVID-19 who were ≥ 19 years of age. The data were collected through an online questionnaire from March 21 to 24, 2022. The assessment tools included the Impact of Event Scale: Revised Korean version, the Connor-Davidson Resilience Scale, the Distress Disclosure Index, the Multidimensional Scale of Perceived Social Support, the Korean version of the Event-related Rumination Inventory, and the Korean version of the Post-traumatic Growth Inventory. Data were analyzed using the IBM SPSS version 24.0 and IBM AMOS 26.0.

RESULTS

The modified model showed appropriate goodness of fit (χ² = 369.90, χ²/degree of freedom = 2.09, SRMR = .09, RMESA = .07, CFI = .94, TLI = .93). The post-traumatic growth of cured patients with COVID-19 was explained through distress perception, self-disclosure, and deliberate rumination, with the explanatory power being 70.0%.

CONCLUSION

This study suggests preparing a disaster psychology program involving experts who can activate deliberate rumination is necessary. Further, this study may serve as basic data for developing a program to enhance the post-traumatic growth of patients cured from COVID-19.

Transdiagnostic factors in symptoms of depression and post-traumatic stress: a systematic review

The current systematic review sought to identify quantitative empirical studies that focused on the transdiagnostic factors of intolerance of uncertainty, emotional dysregulation and rumination, and their relation with depression and post-traumatic stress disorder (PTSD). The overall research aim was to examine the relationship between these transdiagnostic factors and their relation with depression and PTSD symptoms. The systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) guidelines. Out of the 768 articles initially identified, 55 met the inclusion criteria for the current review. The results determined that intolerance of uncertainty is indirectly related to depression and PTSD symptoms, mainly through other factors including emotion dysregulation and rumination. Additionally, emotional dysregulation is a significant predictor of both depression and PTSD symptoms. Rumination is a robust factor related to depression and PTSD symptoms, this relationship was significant in cross-sectional and longitudinal studies. This review provides evidence on the transdiagnostic factors of intolerance of uncertainty, emotional dysregulation and rumination in the relationship with depression and PTSD symptoms.

Post-Traumatic Stress Disorder after the 6.1 Magnitude Earthquake in Piura, Peru: A Cross-Sectional Study

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.

The Impact of Intrusive Rumination on College Students’ Creativity During the COVID-19 Pandemic: The Mediating Effect of Post-traumatic Growth and the Moderating Role of Psychological Resilience

Purpose

College students in the pandemic area are experiencing the problems caused by COVID-19 by themselves or people around them, how to cope with the sudden changes and adjust the psychological stress response, and get experience and grow in the fight against the pandemic is a question worth in-depth discussion. The researchers constructed a mediated regulation model to examine the effects of intrusive rumination on the creativity of college students during the COVID-19 pandemic, as well as the mediating effect of post-traumatic growth and the moderating role of psychological resilience.

Methods

A sample of 475 university students from Guangdong Province, China, were surveyed with the Runco Ideational Behavior Scale, the Event Related Rumination Inventory, the Posttraumatic Growth Inventory, and the Psychological Resilience Scale. SPSS (version 23) and PROCESS (version 3.3) were used for correlation analysis, mediation analysis, and mediated moderation analysis.

Results

(1) Intrusive rumination was positively correlated with post-traumatic growth and creativity but negatively correlated with psychological resilience. Psychological resilience was positively correlated with post-traumatic growth and creativity. Post-traumatic growth and creativity were positively correlated. (2) Post-traumatic growth played a mediating role in the relationship between intrusive rumination and creativity. (3) Psychological resilience moderated the first half of the pathway “intrusive rumination → post-traumatic growth → creativity.”

Conclusion

Intrusive rumination affected creativity directly and also indirectly through post-traumatic growth. At the same time, psychological resilience played a moderating role between intrusive rumination and creativity. The correlation between intrusive rumination and post-traumatic growth was stronger when levels of psychological resilience levels were higher.

Post-Traumatic Growth during COVID-19: The Role of Perceived Social Support, Personality, and Coping Strategies

Although many studies on mental health have been conducted among various populations during the COVID-19 pandemic, few studies have focused on post-traumatic growth (PTG) in the general population. The current study aimed to explore whether perceived social support, personality, and coping strategies are associated with PTG in the COVID-19 pandemic period. The study also investigated whether coping strategies mediate the relations between perceived social support, personality, and PTG. A total of 181 participants (Mage = 24) completed the self-report questionnaire online, which was distributed via various online channels, mainly in China and Sweden. The relations between the study variables were examined with correlation analyses and a multiple mediation analysis. Results showed that more than half of the participants (60.8%) reported experiences of PTG during the pandemic. Additionally, perceived social support, personality traits (extraversion, emotional stability, agreeableness, and conscientiousness) and coping strategies (problem-focused coping, emotion-focused coping, and social support coping) were positively correlated with PTG. In addition, coping strategies (problem-focused coping, emotion-focused coping, and avoidance coping) mediated the relations between perceived social support, personality traits and PTG. Theoretical and practical implications of this study are discussed, concluding that the findings of this study have the potential to guide intervention efforts to promote positive change during the pandemic.

The Impact of General Self-Efficacy on Psychological Resilience During the COVID-19 Pandemic: The Mediating Role of Posttraumatic Growth and the Moderating Role of Deliberate Rumination

Purpose: This study used a moderated mediation model to explore the relationship between general self-efficacy (GSE) and psychological resilience (PR) and the associated mechanisms, the mediating role of posttraumatic growth (PTG), and the moderating role of deliberate rumination (DR) during the coronavirus disease 2019 (COVID-19) pandemic. Knowledge of the relationship between these four variables examined further understanding of the PR improvement mechanism of college students and even the general public. Methods: The college students who participated in this study came from an independent college in Guangdong Province, China. A total of 918 college students completed the survey, and the final data sample size was 881. SPSS 23.0 and PROCESS (version 3.3) were used to conduct Pearson's correlation analysis and hierarchical regression linear analysis on the data. Results: (1) The correlation analysis showed that GSE and PR were positively correlated and that PTG was positively correlated with GSE and PR. DR was positively correlated with GSE, PTG, and PR. (2) The results of mediation analysis showed that GSE had a direct predictive effect on DR, and PTG partially mediated the relationship between the two. (3) The results of moderating effect analysis showed that DR hindered the effect of GSE on PTG but enhanced the positive impact of PTG on PR. Conclusions: General self-efficacy can improve PR under the mediating influence of PTG. DR played a positive moderating role in the relationship between GSE and PTG, and played a negative moderating role in the relationship between PTG and PR. These results advance the understanding of the mechanism between GSE and PR.

Dampening of positive affect is associated with posttraumatic stress following stressful life events

Background: Treatments for posttraumatic stress (PTS) are effective for many but not all people. There is a continued need to further our understanding of psychological mechanisms involved in the development and maintenance of PTS. Research has examined dysregulation of negative affect (NA) in PTS but relatively little attention has been paid to the role of dysregulation of positive affect (PA) in PTS. Objective: The current study sought to examine the incremental role of PA dysregulation - specifically self-focused and emotion-focused rumination (strategies to upregulate PA) and dampening (a strategy downregulating PA) in explaining variance in PTS, while taking into account neuroticism, plus more often-researched processes of NA regulation (i.e. brooding and reflection) and experiential acceptance and mindfulness - broader regulatory styles involved in PTS. Method: Data were available from 473 students who completed measures about stressful life events experienced, PTS, and measures of PA dysregulation and all other variables of interest. Results: Zero order correlations showed that dampening of PA but not self-focused and emotion-focused regulation of PA were associated with PTS total scores and PTS clusters of re-experiencing, avoidance, and hyperarousal. Multiple regression analyses revealed, among other things, that dampening of PA, neuroticism, brooding, and mindfulness (but not emotion-focused and self-focused rumination about PA, reflection, and experiential acceptance) explained unique proportions of variance in PTS when taking into account the shared variance between these variables. Conclusions: Future research may continue addressing difficulties in regulating PA alongside difficulties regulating NA to improve the understanding of mechanisms maintaining PTS and to examine the usefulness of interventions improving PA regulation in the treatment of PTS.

Measuring mental health burden in humanitarian settings: a critical review of assessment tools

BACKGROUND

The effects of disasters and conflicts are widespread and heavily studied. While attention to disasters' impacts on mental health is growing, mental health effects are not well understood due to inconsistencies in measurement.

OBJECTIVE

The purpose of this study is to review mental health assessment tools and their use in populations affected by disasters and conflicts.

METHOD

Tools that assess posttraumatic stress disorder, depression, substance use disorder, and general mental health were examined. This review began with a search for assessment tools in PubMed, PsycINFO, and Google Scholar. Next, validation studies for the tools were obtained through snowball sampling. A final search was conducted for scientific studies using the selected tools in humanitarian settings to collect the data for analysis. The benefits and limitations described for each tool were compiled into a complete table.

RESULTS

Twelve assessment tools were included, with 88 studies using them. The primary findings indicate that half of the studies used the Impact of Events Scale-Revised. The most common limitation discussed is that self-report tools inaccurately estimate the prevalence of mental health problems. This inaccuracy is further exacerbated by a lack of cultural appropriateness of the tools, as many are developed for Western contexts.

CONCLUSION

It is recommended that researchers and humanitarian workers reflect on the effectiveness of the mental health assessment tool they use to accurately represent the populations under study in emergency settings. In addition, mental health assessment should be coupled with action.

Considering the Impact of Early Trauma on Coping and Pathology to Predict Posttraumatic Growth Among 9-1-1 Telecommunicators

Recent research has demonstrated that first responders may report posttraumatic growth (PTG), positive psychological changes that arise in the aftermath of a trauma. Less is known regarding the perception of PTG among 9-1-1 telecommunicators, a group of first responders exposed to a high degree of lifetime trauma, including duty-related trauma as well as early and non-duty-related trauma. Moreover, the impact of childhood trauma on the processes involved in the perception of growth is less clear. While some distress is needed to facilitate processes that lead to the perception of PTG, it has been suggested that positive associations between PTG and pathology reflect avoidant coping or represent an illusory component of PTG. Structural equation models were used to examine early trauma exposure, coping, and pathology in predicting PTG among 9-1-1 telecommunicators (N = 788). In separate models using active and avoidant forms of coping, childhood trauma exposure had an indirect effect on PTG through coping. In a model considering both forms of coping, childhood trauma had an indirect effect on PTG through psychopathology, but not through coping. The results show that early trauma exposure leads to the perception of growth through pathways indicative of both adaptive and maladaptive coping processes.

Social-Ecological Resilience Moderates the Effectiveness of Avoidant Coping in Children Exposed to Adversity: An Exploratory Study in Lithuania

Background

Against the high prevalence of adverse childhood experiences in Lithuania, the government testified a lack of effective ways to address the problem. A crucial endeavor for intervention planners is to identify the risk and protective factors whose interaction may lead at risk children to achieve greater levels of functioning. Internal qualities and external resources can act independently or interactively to reduce the damaging effects of adversities, and to enhance resilience process. In particular, both coping strategies and social resources have been shown to have a consistent influence on trauma-related outcomes.

Objective

The aim of this study was to investigate the potential interaction of coping strategies with external resources in predicting trauma-related outcomes in children exposed to adversities.

Participants and Setting

A sample of 372 Lithuanian children (mean age = 13.03; range: 7-17) with a history of traumatic experiences has been involved.

Methods

The Child and Youth Resilience Measure-Revised (CYRM-R), the Children Coping Strategy Checklist (CCSC), and the Trauma Symptom Checklist for Children (TSCC) have been administered to participants. A moderation analysis was performed to test whether social-ecological resilience moderate the relationship between each coping strategy and trauma-related outcomes. Results: When controlling for sex, age, other coping strategies, and social-ecological resilience, only active coping was found to significantly predict each of the trauma-related symptoms. Furthermore, social-ecological resilience has a negatively moderating effect on the relationship between avoidant coping strategies and depression.

Conclusion

MHPSS professionals who design and implement interventions to enhance the likelihood of resilience among vulnerable children, should take in considerations the multiple interaction between social-ecological resilience and avoidant coping strategies in the children adjustment.

Predicting Posttraumatic Growth in Mothers and Fathers of Critically Ill Children: A Longitudinal Study

Research on parental psychological effects related to a child's critical illness has focused on studying negative outcomes, while the possibility of posttraumatic growth (PTG), defined as the perception of positive changes after a traumatic event, has been overlooked. This study explores the degree of parental PTG after a child's hospitalization in a pediatric intensive care unit (PICU) and the role of resilience, emotions, perceived severity of the child's condition and stress in predicting PTG. In the first 48 h after their child's discharge from a PICU, N = 196 parents were assessed for resilience, emotions, perceived stress, and the degree to which they perceived their child's condition as severe. 6 months later N = 143 parents were assessed PTG. 6 months post discharge, 37.1% of parents reported PTG at least to a medium degree. Path analyses with latent variables showed that the psychological variables assessed at discharge predicted between 20 and 21% of the total variance in PTG. Resilience affected PTG indirectly, through the bias of positive emotions. PTG is a frequent phenomenon. Psychological interventions aimed at encouraging parental PTG after a child's critical admission should focus on boosting resilience and positive emotions.

Relationship Between Self-Perceived Health, Vitality, and Posttraumatic Growth in Liver Transplant Recipients

Our objective was to analyze the differences in posttraumatic growth in 240 liver transplant recipients based on two factors. First, self-perceived health: better (Group 1 = G1) and worse (Group 2 = G2). Second, vitality: more (Group 3 = G3) and less (Group 4 = G4). The Posttraumatic Growth Inventory, SF-36 Health Survey (Item 2) and SF-12 Health Survey (vitality dimension) were used. Firstly, analyzing main effects recipients with better (G1) compared to worse (G2) self-perceived health, showed greater posttraumatic growth. Interaction effects were found on essential posttraumatic growth domains such as new possibilities (p = 0.040), personal strength (p = 0.027), and appreciation of life (p = 0.014). Statistically significant differences showed that among transplant recipients with worse self-perceived health (G2), those with more vitality had higher levels on abovementioned posttraumatic growth dimensions. However, in transplant recipients with better self-perceived health (G1) respective dimensions were not significantly influenced by the level of vitality. Among the recipients with less vitality (G4), those with better self-perceived health showed higher scores on abovementioned posttraumatic growth dimensions. We conclude that positive self-perceived health might compensate for a lack of vitality as well as a high level of vitality may compensate for negative self-perceived health regarding the development of crucial aspects of posttraumatic growth after liver transplantation.

Relationship Between Stressful Life Events and Sleep Quality: Rumination as a Mediator and Resilience as a Moderator

Purpose: The aim of this study was to investigate the relationship between stressful life events and sleep quality and to probe the role of rumination and resilience in the relationship. Method: The Adolescent Self-Rating Life Events Checklist, Ruminative Responses Scale, Connor-Davidson Resilience Scale, and Pittsburgh Sleep Quality Index were used among 1,065 college students. Statistical Product and Service Solutions (SPSS) 20.0 and the SPSS macro Process, which were specifically developed for assessing complex models including both mediators and moderators, were used to analyze the data. Results: High scores of stressful life events predicted worse sleep quality. Rumination partially mediated the relations between stressful life events and sleep quality. Resilience moderated the direct and indirect paths leading from stressful life events to sleep quality. Conclusions: The results demonstrate that stressful life events can directly affect the sleep quality of college students and indirectly through rumination. Additionally, increasing psychological resilience could decrease both the direct effect and the indirect effect of stressful life events affecting sleep quality. The results of this study may contribute to a better understanding of the effects, as well as the paths and conditions, of stressful life events on sleep quality in college students. Moreover, these findings can provide constructive suggestions for improving college students' sleep quality.

Psychometric validation of the PTSD Checklist-5 among female Filipino migrant workers

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.

Associations Among Early Life Stress, Rumination, Symptoms of Psychopathology, and Sex in Youth in the Early Stages of Puberty: a Moderated Mediation Analysis

Despite the high prevalence and substantial costs of early life stress (ELS), the mechanisms through which ELS confers risk for psychopathology are poorly understood, particularly among youth who are in an earlier stage of the transition through puberty. We sought to advance our understanding of the link between ELS and psychopathology by testing whether rumination mediates the relation between ELS and symptoms of psychopathology in youth in the early stages of puberty, and whether sex moderates this mediation. We assessed levels of ELS, both brooding and reflection subtypes of rumination, and internalizing and externalizing symptoms in 170 youth in the early stages of puberty (56% girls) ages 9-13 years. Brooding, but not reflection, mediated the relation between ELS and both internalizing and externalizing symptoms. Importantly, however, sex moderated the relation among ELS, brooding, and symptoms. Specifically, brooding mediated the relation between ELS and both internalizing and externalizing symptoms for girls, but not for boys. Findings support the formulation that brooding is a mechanism linking ELS to multiple forms of behavioral and emotional problems exclusively in girls in the early stages of puberty.

The Benefits of Indirect Exposure to Trauma: The Relationships among Vicarious Posttraumatic Growth, Social Support, and Resilience in Ambulance Personnel in China

OBJECTIVE

Ambulance personnel who witness trauma experienced by patients have been reported to experience positive changes, known as vicarious posttraumatic growth (VPTG). We examined VPTG and its relationship with social support and resilience among ambulance personnel.

METHODS

The sample (n=227) was recruited from six emergency centers in China. The measures included the Posttraumatic Growth Inventory (PTGI), the Social Support Rating Scale (SSRS), and the 10-item Connor-Davidson Resilience Scale (CD-RISC-10). Structure Equation Modeling (SEM) and the bootstrapping procedure were used to examine indirect effects.

RESULTS

The participants' mean score for VPTG was 68.96 (SD=15.51). Social support had significant direct effects on resilience (β=0.51, p<0.001) and VPTG (β=0.25, p=0.001), and resilience (β=0.58, p<0.001) had a significant direct effect on VPTG. Furthermore, social support had a significant indirect effect (0.51×0.58=0.30, p<0.001) on VPTG through resilience.

CONCLUSION

Although the nature of the work of ambulance personnel is not expected to change, the negative effects of the trauma they encounter can be reduced by providing them with more support resources and interventions to foster their resilience, which in turn, promote VPTG.

Affective emotion increases heart rate variability and activates left dorsolateral prefrontal cortex in post-traumatic growth

The present study evaluated the activities of heart rate variability (HRV) and dorsolateral prefrontal cortex (DLPFC) in response to the presentation of affective pictures correlated with posttraumatic growth (PTG) among adults exposed to the Tianjin explosion incident. The participants who were directly involved in the Tianjin explosions were divided into control, post-traumatic stress disorder (PTSD) and PTG group according to the scores of PTSD Checklist-Civilian Version and PTG Inventory survey. All participants received exposure to affective images. Electrocardiogram recording took place during the process for the purpose of analyzing HRV. Meanwhile, functional near-infrared spectroscopy (fNIRS) was used to measure DLPFC activity through hemodynamic response. Our results indicated that, while performing the negative and positive picture stimulating, PTG increased both in low and high frequency components of HRV compared with the control group, but PTSD was not observed in this phenomenon. Moreover, the fNIRS data revealed that PTG had an increased activation in the left DLPFC compared to the control in the condition of negative pictures stimulating, wheras PTSD showed a higher activation in the right DLPFC while receiving positive pictures stimulating. To our knowledge, this is the first study which provides the differences between PTSD and PTG in emotional regulation.

The Characteristics of Emotional Response of Post-traumatic Stress Disorder and Post-traumatic Growth among Chinese Adults Exposed to an Explosion Incident

Purpose

Post-traumatic stress disorder (PTSD) and post-traumatic growth (PTG) are two different outcomes that may occur after experiencing traumatic events. Meanwhile, the traumatic exposure level and emotion response played an important role in the process. The present study first evaluated the relationship between PTSD, PTG, and traumatic exposure level and then compared the characteristics of emotional response through response time of the affective priming paradigm.

Methods

For the purpose of evaluating the relationship between PTSD, PTG, and trauma exposure level, a sample of 2,395 participants completed measures of posttraumatic stress disorder Checklist-Civilian Version (PCL-C), Post-traumatic Growth Inventory (PTGI) and a trauma exposure-related survey, and Pearson’s correlation analysis for the scales were conducted. In order to compare the characteristics of emotional response between PTSD and PTG, we randomly selected 90 participants and divided them into groups of PTSD, PTG, and control according the scores of PCL-C and PTGI, then the 90 participants were asked to do the affective priming task and the response time was recorded, at last analysis of variance was employed to analyze the data.

Results

The results indicated that PTSD was not correlated with PTG. It was positively correlated with the traumatic exposure level, but PTG was not observed in this phenomenon. Finally, the data of response time showed that PTSD required more time to do the priming task and PTG demonstrated no difference compared to the control group.

Conclusion

Combined with previous research findings, the relationship between PTSD and PTG may depend on the type and severity of the trauma, the exposure level, and other such parameters. In terms of positive outcome of trauma PTG displayed no changes of emotional performance from the perspective of behavior. The preliminary results suggested that PTG was more related to a self-reported or self-experienced state.

Latent Profiles of Posttraumatic Growth and Their Relation to Differences in Resilience among Only-Child-Lost People in China

AIMS

Since the early 1980s, the one-child policy has been implemented nationwide in China. A special group called the "only-child-lost family" (OCL family) has emerged and has become a social phenomenon that cannot be ignored. We report latent profiles of posttraumatic growth and their relation to differences in resilience among OCL people in China.

METHODS

A total of 222 OCL people were investigated using the Posttraumatic Growth Inventory and the Connor-Davidson Resilience Scale. Latent profile analysis was applied to explore PTG latent profiles. Multinomial logistic regression was used to analyze the socio-demographic variables in each latent profile and the association between profile membership and resilience.

RESULTS

Three latent profiles were identified and labeled the "high appreciation-power group" (30.6%), the "general moderate growth group" (47.7%) and the "low growth and extreme possibility group" (21.7%). Compared to those in the high appreciation-power group, individuals with monthly income >2000 ($312) were less likely to be in the general moderate growth group (OR = 0.13, P<0.01), whereas individuals with a spouse were less likely to be in the low growth and extreme possibility group (OR = 0.43, P<0.01). Individuals in the "general moderate growth group"(OR = 0.92, P<0.01, 95%CI:0.89-0.94) and the "low growth and extreme possibility" groups (OR = 0.83, P<0.01, 95%CI:0.79-0.87) demonstrated significantly lower levels of resilience compared to the high appreciation-power group.

CONCLUSION

The PTG patterns in only-child-lost parents were varied. Promoting resilience may be a way to foster these parents' PTG. Targeted intervention should be developed based on the characteristics of each latent class, and timely attention must be paid to the mental health of OCL parents who are without a spouse and have low income.

Effect of Positive Psychological Intervention on Posttraumatic Growth among Primary Healthcare Workers in China: A Preliminary Prospective Study

Posttraumatic growth (PTG) is defined as positive psychological change in the wake of highly challenging circumstances. Healthcare workers in particular are more vulnerable to stressors and trauma than the general population. The current study examined the use and effectiveness of a novel positive psychological intervention based on Chinese traditional culture to improve PTG in hospital healthcare workers. The intervention was provided to 579 healthcare workers at hospitals in Guilin, Shenzhen and Xiangtan. Scores on the Posttraumatic Growth Inventory (PTGI) and its subscales were significantly higher after intervention than before (p < 0.001). Of the five aspects of PTG, the aspect of "new possibilities" benefited the most from intervention (Cohen's d = 0.45). PTG in women, nurses and college graduates increased to a greater extent than other participants after intervention. It was concluded that our novel intervention is effective at improving PTG in medical staff.

Stress-Related Symptoms and Suicidal Ideation: The Roles of Rumination and Depressive Symptoms Vary by Gender

There is a growing body of literature suggesting that reactions to stressful life events, such as intrusive thoughts, physiological hyperarousal, and cognitive/behavioral avoidance (i.e., stress-related symptoms) may increase risk for thinking about and attempting suicide. Cognitive vulnerability models have identified rumination (i.e., perseverating on a negative mood) as a maladaptive response that may increase risk for suicidal behavior, as it has also been linked to depression. The present study examined the direct and indirect effects of stress-related symptoms on suicidal ideation through rumination and depressive symptoms. Participants were 1375 young adults, primarily non-White (78 %) females (72 %), recruited from a public university in the Northeastern U.S., who completed measures of stress-related symptoms (as a response to a stressful event), rumination, depressive symptoms, and suicidal ideation. The relation between stress-related symptoms and suicidal ideation was accounted for by the brooding subtype of rumination and depressive symptoms among females. Depressive symptoms, but not rumination, better accounted for suicidal ideation among males. These findings suggest that the role of brooding and depressive symptoms in the relationship between stress-related symptoms and suicidal ideation may vary by gender.