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Sparrow R, Fornells-Ambrojo M. Two people making sense of a story: narrative exposure therapy as a trauma intervention in early intervention in psychosis. Eur J Psychotraumatol 2024; 15:2355829. [PMID: 38856038 PMCID: PMC11168218 DOI: 10.1080/20008066.2024.2355829] [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: 11/19/2023] [Accepted: 04/19/2024] [Indexed: 06/11/2024] Open
Abstract
Background: Narrative exposure therapy (NET) is a recommended intervention for people with multiple trauma histories; however, research is lacking into its use with people experiencing psychosis, many of whom report multiple trauma histories.Objective: This study aimed to explore experiences of NET in early intervention in psychosis (EIP) services.Method: Eight clinicians and four experts with lived experience (experts by experience) of psychosis and multiple trauma were interviewed on a single occasion using two versions (clinician and expert by experience) of a semi-structured interview schedule. Data was analysed using thematic analysis.Results: Five overarching themes were generated, relating to fear and avoidance of memories, importance of trust, organizing memories and making new meaning, reconnecting with emotions, and considerations when delivering NET in EIP.Conclusions: Directly addressing the impact of multiple trauma in people experiencing first episode psychosis is frightening and emotive, but helps to address painful memories and organize them into a personal narrative. Increases in distress and anomalous experiences were carefully considered by clinicians, but typically outweighed by the benefits of NET. Challenges were comparable to those described in non-psychosis research. Implications for clinical practice and future research are outlined.
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Affiliation(s)
- Rachel Sparrow
- Research Department of Clinical, Educational and Health Psychology, University College London, London, UK
| | - Miriam Fornells-Ambrojo
- Research Department of Clinical, Educational and Health Psychology, University College London, London, UK
- Early Intervention in Psychosis Services, North East London NHS Foundation Trust, London, UK
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Novilla MLB, Bird KT, Hanson CL, Crandall A, Cook EG, Obalana O, Brady LA, Frierichs H. U.S. Physicians' Training and Experience in Providing Trauma-Informed Care in Clinical Settings. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:232. [PMID: 38397721 PMCID: PMC10888540 DOI: 10.3390/ijerph21020232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/15/2024] [Revised: 02/10/2024] [Accepted: 02/12/2024] [Indexed: 02/25/2024]
Abstract
Trauma-informed care (TIC) is a comprehensive approach that focuses on the whole individual. It acknowledges the experiences and symptoms of trauma and their impact on health. TIC prioritizes physical and emotional safety through a relationship of trust that supports patient choice and empowerment. It provides a safe and respectful healing environment that considers specific needs while promoting a greater sense of well-being, patient engagement, and partnership in the treatment process. Given the prevalence of trauma, this descriptive cross-sectional study examined the attitudes and perspectives of U.S. physicians (N = 179; 67% males; 84% White; 43% aged 56-65) in providing trauma-informed care using an anonymous 29-item online survey administered by Reaction Data. Findings showed that 16% (n = 18) of physicians estimated that >50% of their patients have a history of trauma. Commonly perceived barriers to providing TIC were resource/time/administrative constraints, provider stress, limited awareness of the right provider to refer patients who experienced trauma, and inadequate TIC emphasis in medical education/training. Expanding physicians' knowledge base of trauma through training and organizational policy/support is crucial in enhancing their TIC competence, particularly in caring for patients with complex care needs whose social determinants increase their risk of exposure to adverse experiences that carry lasting physical and psychological effects.
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Affiliation(s)
- M. Lelinneth B. Novilla
- Department of Public Health, College of Life Sciences, Brigham Young University, Provo, UT 84604, USA; (K.T.B.); (C.L.H.); (A.C.); (E.G.C.); (O.O.); (L.A.B.); (H.F.)
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Yang K, Lu J, Duan L, Tang H, Bao Z, Liu Y, Jiang X. Research hotspots and theme trends in post-traumatic growth: A co-word analysis based on keywords. Int J Nurs Sci 2023; 10:268-275. [PMID: 37128479 PMCID: PMC10148259 DOI: 10.1016/j.ijnss.2023.03.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Revised: 12/27/2022] [Accepted: 03/02/2023] [Indexed: 03/09/2023] Open
Abstract
Objectives To analyze and summarize the research hotspots and advancement of post-traumatic growth (PTG) over the past 15 years based on co-word analysis of keywords, and provide references for PTG-related research and clinical intervention. Methods All studies related to PTG were retrieved from PubMed and Web of Science (WOS) from January 2013 to July 2022. A total of 11 Medical Subject Headings (MeSH) and keywords were used to identify qualified studies. Bibliographic Item Co-occurrence Matrix Builder (BICOMB; version 2.0) was used to conduct high-frequency keywords extraction and matrix setup, Graphical Clustering Toolkit (gCLUTO; version 1.0) was employed to perform clustering analysis, and SPSS (version 25.0) was used to carry out strategic diagram analysis. Results A total of 2,370 publications were selected, from which 38 high-frequency keywords were extracted. The results revealed six research hotspots on PTG during the period from 2013 to 2022, including research on i) emotional reactions after negative life events, ii) PTG among cancer survivors, iii) rumination and resilience after trauma, iv) PTG among children and adolescents, v) role of social support and coping strategy in PTG, and vi) association between PTG and quality of life. Conclusions This co-word analysis effectively reveals an overview of PTG over the past 15 years. The six research categories deduced from this study can reflect that the research content in the field of PTG is abundant, but some research topics have not yet been mature. The findings of this study are of great value to future investigations associated with PTG.
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Primasari I, Hoeboer CM, Bakker A, Olff M. Validation of the Indonesian resilience evaluation scale in an undergraduate student population. BMC Public Health 2022; 22:2410. [PMID: 36550465 PMCID: PMC9783966 DOI: 10.1186/s12889-022-14769-3] [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: 09/19/2022] [Accepted: 11/29/2022] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Psychological resilience is an important factor in coping with Potentially Traumatic Events (PTEs) and might mitigate the development of trauma-related disorders. Due to the high risk of natural disasters, criminal activity, and transportation accidents among the Indonesian population, it is critical to assess psychological resilience as a protective factor. This study aimed to validate the Resilience Evaluation Scale (RES) in Indonesian undergraduate students. METHODS We recruited 327 students (78% female, the mean age is 19.61 (SD = 1.24)) between March and June 2020 using convenience sampling, 256 (78.28%) of whom completed the RES twice with an interval of 2 weeks for test-retest reliability purposes. Parallel Analysis and Exploratory Factor Analysis were performed to examine the construct validity of the RES. The internal consistency and the test-retest reliability were assessed using Cronbach Alpha, Pearson Correlations, and Interclass Correlation Coefficients (ICC). Convergent and divergent validity were examined using Pearson Correlations. RESULTS EFA analysis yielded a two-factor structure for the final eight-item Indonesian version of RES, which reflected two underlying constructs of resilience: self-confidence and self-efficacy. The Indonesian version of RES demonstrated good internal consistency (α = 0.74-0.82) and test-retest reliability (r = 0.68-0.78; ICC = 0.67-0.78). The result showed that the RES total and subscale scores positively correlated with all criterion variables (resilience, self-efficacy, self-esteem, level of global functioning, and adaptive coping strategy; r = 0.27-0.73). RES total and subscale scores negatively correlated with opposite constructs (PTSD, depression, social/work impairment, and maladaptive coping strategy; r = - 0.27- -0.46). CONCLUSIONS The current study showed that the Indonesian RES is a valid and reliable measurement of psychological resilience in Indonesian undergraduate students. The final 8-item Indonesian RES, a freely available resilience instrument, is recommended for future studies and public mental health initiatives in the Indonesian population.
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Affiliation(s)
- Indira Primasari
- grid.509540.d0000 0004 6880 3010Amsterdam UMC location University of Amsterdam, Psychiatry, Meibergdreef 9, Amsterdam, the Netherlands ,Amsterdam Public Health, Mental Health, Amsterdam, The Netherlands ,grid.9581.50000000120191471Faculty of Psychology, Universitas Indonesia, Depok, Indonesia
| | - Chris M. Hoeboer
- grid.509540.d0000 0004 6880 3010Amsterdam UMC location University of Amsterdam, Psychiatry, Meibergdreef 9, Amsterdam, the Netherlands ,Amsterdam Public Health, Mental Health, Amsterdam, The Netherlands
| | - Anne Bakker
- grid.509540.d0000 0004 6880 3010Amsterdam UMC location University of Amsterdam, Psychiatry, Meibergdreef 9, Amsterdam, the Netherlands ,Amsterdam Public Health, Mental Health, Amsterdam, The Netherlands
| | - Miranda Olff
- grid.509540.d0000 0004 6880 3010Amsterdam UMC location University of Amsterdam, Psychiatry, Meibergdreef 9, Amsterdam, the Netherlands ,Amsterdam Public Health, Mental Health, Amsterdam, The Netherlands ,grid.491097.2ARQ National Psychotrauma Centre, Diemen, The Netherlands
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Panayi P, Berry K, Sellwood W, Campodonico C, Bentall RP, Varese F. The Role and Clinical Correlates of Complex Post-traumatic Stress Disorder in People With Psychosis. Front Psychol 2022; 13:791996. [PMID: 35369153 PMCID: PMC8967251 DOI: 10.3389/fpsyg.2022.791996] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2021] [Accepted: 02/07/2022] [Indexed: 11/13/2022] Open
Abstract
Traumatic experiences and post-traumatic stress are highly prevalent in people with psychosis, increasing symptom burden, decreasing quality of life and moderating treatment response. A range of post-traumatic sequelae have been found to mediate the relationship between trauma and psychotic experiences, including the "traditional" symptoms of post-traumatic stress disorder (PTSD). The International Classification of Diseases-11th Edition recognizes a more complex post-traumatic presentation, complex PTSD (cPTSD), which captures both the characteristic symptoms of PTSD alongside more pervasive post-traumatic sequelae known as 'disturbances in self-organization' (DSOs). The prevalence and impact of cPTSD and DSOs in psychosis remains to be explored. In the first study of this kind, 144 participants with psychosis recruited from North West United Kingdom mental health services completed measures assessing trauma, PTSD and cPTSD symptoms and symptoms of psychosis. Forty-percent of the sample met criteria for cPTSD, compared to 10% who met diagnostic criteria for PTSD. PTSD and DSOs mediated the relationship between trauma and positive symptoms, controlling for dataset membership. Both PTSD and DSOs mediated the relationship between trauma and affective symptoms but did not explain a significant proportion of variance in negative symptoms. Cognitive and excitative symptoms of psychosis did not correlate with trauma, PTSD or DSO scores. These findings indicate the possible value of adjunct therapies to manage cPTSD symptoms in people with psychosis, pending replication in larger epidemiological samples and longitudinal studies.
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Affiliation(s)
- Peter Panayi
- Division of Psychology and Mental Health, Manchester Academic Health Sciences Centre, University of Manchester, Manchester, United Kingdom
- Complex Trauma and Resilience Research Unit, Greater Manchester Mental Health NHS Foundation Trust, Manchester, United Kingdom
| | - Katherine Berry
- Division of Psychology and Mental Health, Manchester Academic Health Sciences Centre, University of Manchester, Manchester, United Kingdom
- Complex Trauma and Resilience Research Unit, Greater Manchester Mental Health NHS Foundation Trust, Manchester, United Kingdom
| | - William Sellwood
- Faculty of Health & Medicine, Division of Health Research, University of Lancaster, Lancaster, United Kingdom
| | - Carolina Campodonico
- School of Psychology and Computer Science, University of Central Lancashire, Lancashire, United Kingdom
| | - Richard P. Bentall
- Department of Psychology, University of Sheffield, Sheffield, United Kingdom
| | - Filippo Varese
- Division of Psychology and Mental Health, Manchester Academic Health Sciences Centre, University of Manchester, Manchester, United Kingdom
- Complex Trauma and Resilience Research Unit, Greater Manchester Mental Health NHS Foundation Trust, Manchester, United Kingdom
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Chu Y, Zhang Y, Wang S, Dai H. Resilience mediates the influence of hope, optimism, social support, and stress on anxiety severity among Chinese patients with cervical spondylosis. Front Psychiatry 2022; 13:997541. [PMID: 36213904 PMCID: PMC9539388 DOI: 10.3389/fpsyt.2022.997541] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Accepted: 08/29/2022] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVE Cervical spondylosis (CS) is a potential stressor threatening mental health among affected individuals. This study was to analyze resilience level and associated factors among cervical spondylosis (CS) patients, and to explore the underlying mechanism of anxiety based on resilience-focused psychological variables. METHODS Resilience Scale-14 (RS-14), Zung Self-Rating Anxiety Scale (SAS), Herth Hope Index (HHI), Revised Life Orientation Test (LOT-R), Multidimensional Scale of Perceived Social Support (MSPSS), Perceived Stress Scale-10 (PSS-10) were used in this cross-sectional investigation among 250 CS patients. RESULTS The score of resilience was 65.58 ± 16.14. Hierarchical linear regression analysis revealed that hope, optimism, perceived social support, perceived stress, and whether having comorbid chronic diseases were the independent associates of resilience among CS patients, which explained 63.9% of the total variance. The structural equation model showed that hope, optimism, perceived social support and perceived stress affected anxiety via resilience, and hope and optimism also had direct effects on anxiety. CONCLUSION Chinese patients with CS had moderate level of mental resilience, which was independently related to hope, optimism, perceived social support, perceived stress, and whether having comorbid chronic diseases. Resilience played a mediating role between various psychological variables and anxiety. Improving the level of resilience, hope, optimism and perceived social support and reducing the level of perceived stress are important strategies to reduce anxiety level. Relevant healthcare professionals should put more focus on the mental problems of Chinese CS patients and help maintain good psychological status by improving their resilience and associated psychological variables thereof.
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Affiliation(s)
- Yuying Chu
- School of Nursing, Jinzhou Medical University, Jinzhou, Liaoning, China
| | - Yuqiang Zhang
- The First Affiliated Hospital, Jinzhou Medical University, Jinzhou, Liaoning, China
| | - Suyan Wang
- Centre for Mental Health Guidance, Jinzhou Medical University, Jinzhou, Liaoning, China
| | - Hongliang Dai
- School of Nursing, Jinzhou Medical University, Jinzhou, Liaoning, China
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