1
|
Parker VL, Liechty JM, Cantoni NP. Associations Between Trauma and Health Behaviors and Outcomes Among Sexual Minoritized Adults: A Scoping Review. TRAUMA, VIOLENCE & ABUSE 2024:15248380241233270. [PMID: 38415318 DOI: 10.1177/15248380241233270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/29/2024]
Abstract
Sexual minoritized (SM) adults experience health disparities and report higher rates of trauma history compared to heterosexual adults. This scoping review synthesizes the extant literature that investigates associations between trauma and physical health among SM adults. It also describes research instruments utilized to assess trauma in relation to health outcomes among SM adults. We searched CINAHL, LGBT+ Life, PsycINFO, and PubMed to identify studies meeting inclusion criteria: peer-reviewed, English, assessed trauma as an independent variable, and assessed health behaviors or outcomes among SM adults. From 587 nonduplicate articles, 69 full texts were reviewed; 18 met criteria and were included in this review. To enhance rigor, we utilized the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Scoping Reviews checklist. Most (n = 12) of the included studies were cross-sectional. Trauma was assessed 16 different ways, including 9 validated measures, in relation to 5 health behaviors and 17 health conditions. Trauma was operationalized by history of childhood sexual abuse, adverse childhood experiences, lifetime rape, current symptoms of post-traumatic stress disorder, and lifetime victimization among SM adults. All but one study found associations between trauma and one or more unfavorable health behaviors or outcomes. Studies used widely heterogeneous instruments to assess trauma, health, and SM identity. Greater specification and standardization of measurement is needed, along with contextualized assessments of trauma and its impact on health such as sexual minority stress-related victimization and resilience, and post-traumatic growth and recovery processes.
Collapse
Affiliation(s)
| | - Janet M Liechty
- University of Illinois, Urbana-Champaign, USA
- Carle-Illinois College of Medicine, University of Illinois, Urbana-Champaign, USA
| | | |
Collapse
|
2
|
Brodbeck J, Bötschi SIR, Vetsch N, Stallmann L, Löchner J, Berger T, Schmidt SJ, Marmet S. Fostering resilience and well-being in emerging adults with adverse childhood experiences: study protocol for a randomized controlled trial to evaluate the FACE self-help app. BMC Psychol 2024; 12:84. [PMID: 38374126 PMCID: PMC10877810 DOI: 10.1186/s40359-024-01560-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2024] [Accepted: 01/29/2024] [Indexed: 02/21/2024] Open
Abstract
BACKGROUND Adverse childhood experiences (ACE) are linked to an increased risk of psychological disorders and lower psychosocial functioning throughout life. This study aims to evaluate the FACE self-help app, designed to promote resilience and well-being in emerging adults with a history of ACE. The app is based on cognitive-behavioural principles and consists of two thematic components: (1) self- and emotion regulation (SER) and (2) social skills and biases in social information processing (SSIP). METHODS The efficacy of the app will be tested through a single-centre, two-arm randomized controlled trial, comparing an active intervention group against a waiting list control group. The active group is divided into two subgroups, in which the two components are delivered in a different order to investigate differential effects in a crossover design. Up to 250 emerging adults aged 18 to 25 years with a history of ACE from a general population cohort study will be recruited. The primary objective is to test the efficacy of the app in improving resilience (primary outcome) and well-being (co-primary outcome) compared to a waiting list control group and to examine the stability of these effects. The secondary objectives include testing the efficacy of the app in improving the secondary outcomes, i.e., self-efficacy in managing emotions, problem solving, fear of evaluation, social avoidance, and self-esteem; examining the differential effects of the two components; and assessing the effect of the app on real-life data on resilience, affective states, distress in social interactions and coping strategies. Furthermore, the study will investigate potential moderators (e.g. ACE severity) and mediators of intervention outcomes (e.g. self-efficacy in managing emotions). DISCUSSION The results will provide insights into the efficacy of the self-help intervention as well as mediators and moderators of outcomes. Furthermore, results will extend the existing knowledge by testing the differential effects of the SER and SSIP component on the outcomes. Findings can inform improvements to the FACE app and the development of other interventions for this target group and assess its potential as a scalable, low-threshold intervention to support emerging adults with a history of ACE in their transition to adulthood. TRIAL REGISTRATION NUMBER NCT05824182.
Collapse
Affiliation(s)
- Jeannette Brodbeck
- School of Social Work, University of Applied Sciences and Arts Northwestern Switzerland, Riggenbachstrasse 16, CH-4600, Olten, Switzerland.
- Department of Clinical Psychology, University of Bern, Fabrikstrasse 8, CH-3012, Bern, Switzerland.
| | - Salome I R Bötschi
- School of Social Work, University of Applied Sciences and Arts Northwestern Switzerland, Riggenbachstrasse 16, CH-4600, Olten, Switzerland
| | - Neela Vetsch
- School of Social Work, University of Applied Sciences and Arts Northwestern Switzerland, Riggenbachstrasse 16, CH-4600, Olten, Switzerland
| | - Lina Stallmann
- School of Social Work, University of Applied Sciences and Arts Northwestern Switzerland, Riggenbachstrasse 16, CH-4600, Olten, Switzerland
- Swiss Center for Affective Science, University of Geneva, Chemin des Mines 9, CH-1202, Geneva, Switzerland
| | - Johanna Löchner
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital of Psychiatry and Psychotherapy, Tuebingen, Germany
| | - Thomas Berger
- Department of Clinical Psychology, University of Bern, Fabrikstrasse 8, CH-3012, Bern, Switzerland
| | - Stefanie J Schmidt
- Department of Clinical Child and Adolescent Psychology, University of Bern, Fabrikstrasse 8, CH-3012, Bern, Switzerland
| | - Simon Marmet
- School of Social Work, University of Applied Sciences and Arts Northwestern Switzerland, Riggenbachstrasse 16, CH-4600, Olten, Switzerland
| |
Collapse
|
3
|
Glad KA, Aakvaag HF, Wentzel-Larsen T, Dyb G, Thoresen S. What will others think of me? The longitudinal association between trauma-related shame and guilt and psychopathology after a terror attack. BJPsych Open 2024; 10:e30. [PMID: 38205599 PMCID: PMC10790223 DOI: 10.1192/bjo.2023.624] [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: 05/02/2023] [Revised: 11/09/2023] [Accepted: 11/14/2023] [Indexed: 01/12/2024] Open
Abstract
BACKGROUND Trauma-related shame and guilt have been identified as important factors for mental health following interpersonal trauma. For survivors of terror and disasters, however, the role of shame and guilt remains largely unknown. AIMS To explore the long-term occurrence of trauma-related shame and guilt among survivors of a terror attack, and the potential importance of these emotions for mental health. METHOD A total of 347 survivors (48.7% female, mean age at the time of the attack: 19.25 years, s.d. = 4.40) of the 2011 massacre on Utøya island, Norway, participated in face-to-face, semi-structured interviews. Trauma-related shame and guilt were measured with items from the Shame and Guilt After Trauma Scale at 2.5 and 8.5 years post-terror attack. Post-traumatic reactions and anxiety/depression at 8.5 years post-terror attack were measured with the University of California at Los Angeles PTSD Reaction Index and the Hopkins Symptom Checklist-25, respectively. Associations between trauma-related shame/guilt and post-trauma psychopathology were analysed by multiple linear regressions. RESULTS Trauma-related shame and guilt were prevalent among survivors at both 2.5 and 8.5 years post-terror attack. In unadjusted analyses, shame and guilt, at both time points, were significantly associated with post-traumatic stress reactions and anxiety/depression. Shame remained significantly associated with mental health when adjusted for guilt. Both earlier and current shame were uniquely related to mental health. CONCLUSIONS Trauma-related shame and guilt may be prevalent in survivors of mass trauma several years after the event. Shame, in particular, may play an important role for long-term mental health. Clinicians may find it helpful to explicitly address shame in treatment of mass trauma survivors.
Collapse
Affiliation(s)
- Kristin Alve Glad
- Division for Disasters, Terror and Stress Management, Norwegian Centre for Violence and Traumatic Stress Studies (NKVTS), Oslo, Norway
| | - Helene Flood Aakvaag
- Division for Disasters, Terror and Stress Management, Norwegian Centre for Violence and Traumatic Stress Studies (NKVTS), Oslo, Norway
| | - Tore Wentzel-Larsen
- Division for Disasters, Terror and Stress Management, Norwegian Centre for Violence and Traumatic Stress Studies (NKVTS), Oslo, Norway; and Division for Service Research and Innovation, Centre for Child and Adolescent Mental Health, Eastern and Southern Norway, Oslo, Norway
| | - Grete Dyb
- Division for Disasters, Terror and Stress Management, Norwegian Centre for Violence and Traumatic Stress Studies (NKVTS), Oslo, Norway; and Institute of Clinical Medicine, University of Oslo, Norway
| | - Siri Thoresen
- Division for Disasters, Terror and Stress Management, Norwegian Centre for Violence and Traumatic Stress Studies (NKVTS), Oslo, Norway; and Department of Psychology, University of Oslo, Norway
| |
Collapse
|
4
|
Theodoratou M, Kougioumtzis GA, Yotsidi V, Sofologi M, Katsarou D, Megari K. Neuropsychological Consequences of Massive Trauma: Implications and Clinical Interventions. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:2128. [PMID: 38138231 PMCID: PMC10744839 DOI: 10.3390/medicina59122128] [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: 11/01/2023] [Revised: 11/24/2023] [Accepted: 11/29/2023] [Indexed: 12/24/2023]
Abstract
Traumatic events, especially massive trauma resulting from catastrophic incidents, wars, or severe abuse can elicit significant neuropsychological alterations, with profound implications for cognitive, emotional, and behavioral functioning. This mini-review delineates the primary neural changes post-trauma and underscores the importance of timely neuropsychological and clinical interventions. Specific brain regions, including the amygdala and prefrontal cortex, undergo physiological changes that can lead to memory impairments, attention deficits, and emotional disturbances. PTSD, a commonly diagnosed condition post-trauma, exemplifies the intricate relationship between trauma and memory processing. Furthermore, the concept of neuroplasticity, the brain's inherent ability to adapt and rewire, offers hope for recovery. Current clinical interventions, such as cognitive behavioral therapy, mindfulness practices, and biofeedback, leverage this neuroplastic potential to foster healing. The review underscores the vital importance of early intervention to mitigate long-term neuropsychological impacts, emphasizing the role of timely and targeted clinical interventions. The synthesis of this knowledge is crucial for clinicians, allowing for informed therapeutic approaches that holistically address both the physiological and psychological dimensions of trauma.
Collapse
Affiliation(s)
- Maria Theodoratou
- Department of Psychology, School of Health Sciences, Neapolis University Pafos, Paphos 8042, Cyprus; (G.A.K.); (M.S.); (D.K.)
- Department of Social Sciences, Hellenic Open University, 263 35 Patras, Greece;
| | - Georgios A. Kougioumtzis
- Department of Psychology, School of Health Sciences, Neapolis University Pafos, Paphos 8042, Cyprus; (G.A.K.); (M.S.); (D.K.)
- Department of Social Sciences, Hellenic Open University, 263 35 Patras, Greece;
- Department of Turkish Studies and Modern Asian Studies, Faculty of Economic and Political Sciences, National and Kapodistrian University of Athens, 157 72 Athens, Greece
| | - Vasiliki Yotsidi
- Department of Social Sciences, Hellenic Open University, 263 35 Patras, Greece;
- Department of Psychology, Panteion University of Social and Political Sciences, 157 72 Athens, Greece
| | - Maria Sofologi
- Department of Psychology, School of Health Sciences, Neapolis University Pafos, Paphos 8042, Cyprus; (G.A.K.); (M.S.); (D.K.)
- Laboratory of Psychology, Department of Early Childhood Education, School of Education, University of Ioannina, 451 10 Ioannina, Greece
- Institute of Humanities and Social Sciences, University Research Centre of Ioannina (U.R.C.I.), 451 10 Ioannina, Greece
| | - Dimitra Katsarou
- Department of Psychology, School of Health Sciences, Neapolis University Pafos, Paphos 8042, Cyprus; (G.A.K.); (M.S.); (D.K.)
- Department of Preschool Education Sciences and Educational Design, Faculty of Humanities, University of the Aegean, 811 00 Mytilene, Greece
| | - Kalliopi Megari
- City College, University of York, Europe Campus, 546 26 Thessaloniki, Greece;
- Department of Psychology, School of Social Sciences, UOWM, 531 00 Florina, Greece
- School of Psychology, Aristotle University of Thessaloniki, 541 24 Thessaloniki, Greece
| |
Collapse
|
5
|
Sassoon SA, Fama R, Le Berre AP, Müller-Oehring EM, Zahr NM, Pfefferbaum A, Sullivan EV. Influence of childhood trauma, HIV infection, alcohol use disorder, and resilience on health-related quality of life in adulthood. J Psychiatr Res 2023; 163:230-239. [PMID: 37230007 DOI: 10.1016/j.jpsychires.2023.05.033] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Revised: 04/26/2023] [Accepted: 05/03/2023] [Indexed: 05/27/2023]
Abstract
Experience of childhood trauma, especially physical, emotional, and sexual abuse, carries a risk for developing alcohol use disorder (AUD) and engaging in risky behaviors that can result in HIV infection. AUD and HIV are associated with compromised self-reported health-related quality of life (HRQoL) possibly intersecting with childhood trauma. To determine whether poor HRQoL is heightened by AUD, HIV, their comorbidity (AUD + HIV), number of trauma events, or poor resilience, 108 AUD, 45 HIV, 52 AUD + HIV, and 67 controls completed the SF-21 HRQoL, Brief Resilience Scale (BRS), Ego Resiliency Scale (ER-89), and an interview about childhood trauma. Of the 272 participants, 116 reported a trauma history before age 18. Participants had a blood draw, AUDIT questionnaire, and interview about lifetime alcohol consumption. AUD, HIV, and AUD + HIV had lower scores on HRQoL and resilience composite comprising the BRS and ER-89 than controls. Greater resilience was a significant predictor of better quality of life in all groups. HRQoL was differentially moderated in AUD and HIV: more childhood traumas predicted poorer quality of life in AUD and controls, whereas higher T-lymphocyte count contributed to better quality of life in HIV. This study is novel in revealing a detrimental impact on HRQoL from AUD, HIV, and their comorbidity, with differential negative contribution from trauma and beneficial effect of resilience to quality of life. Channeling positive effects of resilience and reducing the incidence and negative impact of childhood trauma may have beneficial effects on health-related quality of life in adulthood independent of diagnosis.
Collapse
Affiliation(s)
| | - Rosemary Fama
- SRI International, Biosciences Division, Menlo Park, CA, 94025, USA; Stanford University School of Medicine, Department of Psychiatry and Behavioral Sciences, Stanford, CA, 94305, USA
| | - Anne-Pascale Le Berre
- Stanford University School of Medicine, Department of Psychiatry and Behavioral Sciences, Stanford, CA, 94305, USA
| | - Eva M Müller-Oehring
- SRI International, Biosciences Division, Menlo Park, CA, 94025, USA; Stanford University School of Medicine, Department of Psychiatry and Behavioral Sciences, Stanford, CA, 94305, USA
| | - Natalie M Zahr
- Stanford University School of Medicine, Department of Psychiatry and Behavioral Sciences, Stanford, CA, 94305, USA
| | - Adolf Pfefferbaum
- SRI International, Biosciences Division, Menlo Park, CA, 94025, USA; Stanford University School of Medicine, Department of Psychiatry and Behavioral Sciences, Stanford, CA, 94305, USA
| | - Edith V Sullivan
- Stanford University School of Medicine, Department of Psychiatry and Behavioral Sciences, Stanford, CA, 94305, USA
| |
Collapse
|
6
|
Papini S, Norman SB, Campbell-Sills L, Sun X, He F, Kessler RC, Ursano RJ, Jain S, Stein MB. Development and Validation of a Machine Learning Prediction Model of Posttraumatic Stress Disorder After Military Deployment. JAMA Netw Open 2023; 6:e2321273. [PMID: 37389870 PMCID: PMC10314304 DOI: 10.1001/jamanetworkopen.2023.21273] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/24/2022] [Accepted: 05/16/2023] [Indexed: 07/01/2023] Open
Abstract
Importance Military deployment involves significant risk for life-threatening experiences that can lead to posttraumatic stress disorder (PTSD). Accurate predeployment prediction of PTSD risk may facilitate the development of targeted intervention strategies to enhance resilience. Objective To develop and validate a machine learning (ML) model to predict postdeployment PTSD. Design, Setting, and Participants This diagnostic/prognostic study included 4771 soldiers from 3 US Army brigade combat teams who completed assessments between January 9, 2012, and May 1, 2014. Predeployment assessments occurred 1 to 2 months before deployment to Afghanistan, and follow-up assessments occurred approximately 3 and 9 months post deployment. Machine learning models to predict postdeployment PTSD were developed in the first 2 recruited cohorts using as many as 801 predeployment predictors from comprehensive self-report assessments. In the development phase, cross-validated performance metrics and predictor parsimony were considered to select an optimal model. Next, the selected model's performance was evaluated with area under the receiver operating characteristics curve and expected calibration error in a temporally and geographically distinct cohort. Data analyses were performed from August 1 to November 30, 2022. Main Outcomes and Measures Posttraumatic stress disorder diagnosis was assessed by clinically calibrated self-report measures. Participants were weighted in all analyses to address potential biases related to cohort selection and follow-up nonresponse. Results This study included 4771 participants (mean [SD] age, 26.9 [6.2] years), 4440 (94.7%) of whom were men. In terms of race and ethnicity, 144 participants (2.8%) identified as American Indian or Alaska Native, 242 (4.8%) as Asian, 556 (13.3%) as Black or African American, 885 (18.3%) as Hispanic, 106 (2.1%) as Native Hawaiian or other Pacific Islander, 3474 (72.2%) as White, and 430 (8.9%) as other or unknown race or ethnicity; participants could identify as of more than 1 race or ethnicity. A total of 746 participants (15.4%) met PTSD criteria post deployment. In the development phase, models had comparable performance (log loss range, 0.372-0.375; area under the curve range, 0.75-0.76). A gradient-boosting machine with 58 core predictors was selected over an elastic net with 196 predictors and a stacked ensemble of ML models with 801 predictors. In the independent test cohort, the gradient-boosting machine had an area under the curve of 0.74 (95% CI, 0.71-0.77) and low expected calibration error of 0.032 (95% CI, 0.020-0.046). Approximately one-third of participants with the highest risk accounted for 62.4% (95% CI, 56.5%-67.9%) of the PTSD cases. Core predictors cut across 17 distinct domains: stressful experiences, social network, substance use, childhood or adolescence, unit experiences, health, injuries, irritability or anger, personality, emotional problems, resilience, treatment, anxiety, attention or concentration, family history, mood, and religion. Conclusions and Relevance In this diagnostic/prognostic study of US Army soldiers, an ML model was developed to predict postdeployment PTSD risk with self-reported information collected before deployment. The optimal model showed good performance in a temporally and geographically distinct validation sample. These results indicate that predeployment stratification of PTSD risk is feasible and may facilitate the development of targeted prevention and early intervention strategies.
Collapse
Affiliation(s)
- Santiago Papini
- Department of Psychiatry, University of California, San Diego, La Jolla
- Division of Research, Kaiser Permanente Northern California, Oakland
| | - Sonya B. Norman
- Department of Psychiatry, University of California, San Diego, La Jolla
- National Center for PTSD, White River Junction, Vermont
- Veterans Affairs Center of Excellence for Stress and Mental Health, San Diego, California
| | | | - Xiaoying Sun
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California, San Diego, La Jolla
| | - Feng He
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California, San Diego, La Jolla
| | - Ronald C. Kessler
- Department of Health Care Policy, Harvard Medical School, Boston, Massachusetts
| | - Robert J. Ursano
- Center for the Study of Traumatic Stress, Department of Psychiatry, Uniformed Services University of the Health Sciences, Bethesda, Maryland
| | - Sonia Jain
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California, San Diego, La Jolla
| | - Murray B. Stein
- Department of Psychiatry, University of California, San Diego, La Jolla
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California, San Diego, La Jolla
- Psychiatry Service, Veterans Affairs San Diego Healthcare System, San Diego, California
| |
Collapse
|
7
|
Al Jowf GI, Ahmed ZT, Reijnders RA, de Nijs L, Eijssen LMT. To Predict, Prevent, and Manage Post-Traumatic Stress Disorder (PTSD): A Review of Pathophysiology, Treatment, and Biomarkers. Int J Mol Sci 2023; 24:ijms24065238. [PMID: 36982313 PMCID: PMC10049301 DOI: 10.3390/ijms24065238] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Revised: 02/28/2023] [Accepted: 03/07/2023] [Indexed: 03/11/2023] Open
Abstract
Post-traumatic stress disorder (PTSD) can become a chronic and severely disabling condition resulting in a reduced quality of life and increased economic burden. The disorder is directly related to exposure to a traumatic event, e.g., a real or threatened injury, death, or sexual assault. Extensive research has been done on the neurobiological alterations underlying the disorder and its related phenotypes, revealing brain circuit disruption, neurotransmitter dysregulation, and hypothalamic–pituitary–adrenal (HPA) axis dysfunction. Psychotherapy remains the first-line treatment option for PTSD given its good efficacy, although pharmacotherapy can also be used as a stand-alone or in combination with psychotherapy. In order to reduce the prevalence and burden of the disorder, multilevel models of prevention have been developed to detect the disorder as early as possible and to reduce morbidity in those with established diseases. Despite the clinical grounds of diagnosis, attention is increasing to the discovery of reliable biomarkers that can predict susceptibility, aid diagnosis, or monitor treatment. Several potential biomarkers have been linked with pathophysiological changes related to PTSD, encouraging further research to identify actionable targets. This review highlights the current literature regarding the pathophysiology, disease development models, treatment modalities, and preventive models from a public health perspective, and discusses the current state of biomarker research.
Collapse
Affiliation(s)
- Ghazi I. Al Jowf
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience (MHeNs), Faculty of Health, Medicine and Life Sciences, Maastricht University Medical Centre, 6200 MD Maastricht, The Netherlands
- Department of Public Health, College of Applied Medical Sciences, King Faisal University, Al-Ahsa 31982, Saudi Arabia
- European Graduate School of Neuroscience, Maastricht University, 6200 MD Maastricht, The Netherlands
- Correspondence: (G.I.A.J.); (L.M.T.E.)
| | - Ziyad T. Ahmed
- College of Medicine, Sulaiman Al Rajhi University, Al-Bukairyah 52726, Saudi Arabia
| | - Rick A. Reijnders
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience (MHeNs), Faculty of Health, Medicine and Life Sciences, Maastricht University Medical Centre, 6200 MD Maastricht, The Netherlands
- European Graduate School of Neuroscience, Maastricht University, 6200 MD Maastricht, The Netherlands
| | - Laurence de Nijs
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience (MHeNs), Faculty of Health, Medicine and Life Sciences, Maastricht University Medical Centre, 6200 MD Maastricht, The Netherlands
- European Graduate School of Neuroscience, Maastricht University, 6200 MD Maastricht, The Netherlands
| | - Lars M. T. Eijssen
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience (MHeNs), Faculty of Health, Medicine and Life Sciences, Maastricht University Medical Centre, 6200 MD Maastricht, The Netherlands
- European Graduate School of Neuroscience, Maastricht University, 6200 MD Maastricht, The Netherlands
- Department of Bioinformatics—BiGCaT, School of Nutrition and Translational Research in Metabolism (NUTRIM), Faculty of Health, Medicine and Life Sciences, Maastricht University, 6200 MD Maastricht, The Netherlands
- Correspondence: (G.I.A.J.); (L.M.T.E.)
| |
Collapse
|
8
|
Laughon K, Montalvo‐Liendo N, Eaton S, Bassett L. Health and safety concerns of female asylum seekers living in an informal migrant camp in Matamoros, Mexico. J Adv Nurs 2022; 79:1830-1839. [PMID: 36419258 DOI: 10.1111/jan.15511] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2022] [Revised: 10/19/2022] [Accepted: 11/10/2022] [Indexed: 11/27/2022]
Abstract
BACKGROUND Whilst increased numbers of people worldwide exercise their human right to seek asylum, the US has greatly reduced the number of asylum seekers able to enter its southern border, resulting in informal encampments. Women and children are uniquely vulnerable to violence and other health risks. AIM To describe the health and safety concerns of female asylum seekers living in an informal migrant camp, with a particular focus on the risks of violence against women and children. METHODS For this qualitative descriptive study, female asylum seekers were purposively recruited in an informal tent encampment in Matamoros, Mexico (n = 43). Semi-structured interviews were conducted in January and February 2020. Qualitative data were analysed using thematic analysis. RESULTS The themes identified were constant vigilance, the effects of constant vigilance, lack of resources, and uncertainty. Women's unrelenting fears about their own safety and that of their children impacted their ability to access the camp's meagre resources and exacerbated negative effects on women and children. CONCLUSION Applying established guidelines and best practices for health and safety in humanitarian settings could mitigate threats to women and children. Additionally, camp conditions represent human rights violations. Nurses have an ethical duty to advocate for an end to the US policies creating and maintaining this humanitarian crisis. IMPACT As a result of changes to the United States immigration policy, individuals seeking asylum at the Southern border of the US have been largely prevented from entering the US since early 2018. Asylum seekers living in an informal encampment on the border awaiting entry describe a public health, humanitarian and human rights crisis. Women in this already vulnerable group lacked necessities, such as housing, food security, potable water, protection against gender violence and other forms of physical threats to themselves and their children. This created a heightened sense of vigilance and fear, with implications for their mental health and well-being and that of their children. These findings highlight the need for governmental and international organizations to implement the best health and safety practices for humanitarian settings to ensure equity in relation to the social determinants of health. Nurses have an ethical obligation to be strong human rights advocates. PATIENT OR PUBLIC CONTRIBUTIONS One member of the research team has extensive experience as an advocate for recently immigrated women experiencing intimate partner violence. The study procedures were reviewed with advocates providing direct services to migrant women and children.
Collapse
Affiliation(s)
- Kathryn Laughon
- School of Nursing University of Virginia Charlottesville Virginia USA
| | | | - Sarah Eaton
- School of Nursing University of Virginia Charlottesville Virginia USA
| | - Lucy Bassett
- Frank Batten School of Leadership and Public Policy University of Virginia Charlottesville Virginia USA
| |
Collapse
|
9
|
Family-Based Prevention of Child Traumatic Stress. Pediatr Clin North Am 2022; 69:633-644. [PMID: 35934490 PMCID: PMC9554837 DOI: 10.1016/j.pcl.2022.04.011] [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] [Indexed: 11/23/2022]
Abstract
Most children experience potentially traumatic events, and some develop significant emotional and behavioral difficulties in response. Although the field has mainly focused on treatment, a prevention framework provides an alternate approach to reducing the public health burden of trauma. Because parents and families can affect children's trauma exposure and reactions, family-based preventive interventions represent a unique opportunity to address child traumatic stress. This article discusses family-based programs that address child traumatic stress across 3 categories: preventing children's exposure to traumatic events, preventing traumatic stress reactions following exposure, and preventing negative long-term sequelae of trauma.
Collapse
|
10
|
Salter M, Hall H. Reducing Shame, Promoting Dignity: A Model for the Primary Prevention of Complex Post-Traumatic Stress Disorder. TRAUMA, VIOLENCE & ABUSE 2022; 23:906-919. [PMID: 33345743 DOI: 10.1177/1524838020979667] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Complex post-traumatic stress disorder (CPTSD) refers to the complex psychological and psychosocial sequelae caused by prolonged interpersonal abuse. Contemporary approaches to CPTSD are dominated by individualized psychological interventions that are long term and costly. However, accumulating evidence indicates that CPTSD is a high prevalence mental illness implicated in significant social problems, with a pattern of lateral and intergenerational transmission that impacts on already disadvantaged communities. Consequently, there have been calls for a public health model for the prevention of CPSTD; however, there has been a lack of clarity as to what this should entail. This article argues that empirical and conceptual shifts framing CPTSD as a shame disorder offers new preventative opportunities. The article presents a series of interconnected literature reviews including a review of available prevalence data on CPTSD, the public health implications of CPTSD, the role of shame and humiliation in CPTSD, and current scholarship on dignity in public policy and professional practice. Drawing on these reviews, this article develops a social ecological model of primary prevention to CPTSD with a focus on the reduction of shame and the promotion of dignity at the relational, community, institutional, and macrolevel. A broad overview of this model is provided with examples of preventative programs and interventions. While the epidemiology of CPTSD is still emerging, this article argues that this model provides the conceptual foundations necessary for the coordination of preventative interventions necessary to reduce to the risk and prevalence of CPSTD.
Collapse
Affiliation(s)
- Michael Salter
- School of Social Sciences, University of New South Wales, Sydney, Australia
| | - Heather Hall
- International Society for the Study of Trauma and Dissociation, Arlington, VA, USA
| |
Collapse
|
11
|
Asadi F, Hosseini MA, Almasi S. Reliability of trauma coding with ICD-10. Chin J Traumatol 2022; 25:102-106. [PMID: 34419337 PMCID: PMC9039840 DOI: 10.1016/j.cjtee.2021.08.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Revised: 04/28/2021] [Accepted: 06/29/2021] [Indexed: 02/04/2023] Open
Abstract
PURPOSE The reliability of trauma coding is essential in establishing the reliable trauma data and adopting efficient control and monitoring policies. The present study aimed to determine the reliability of trauma coding in educational hospitals affiliated to Shahid Beheshti University of Medical Sciences, Iran. METHODS In this descriptive cross-sectional study, 591 coded medical records with a trauma diagnosis in 2018 were selected and recoded by two coders. The reliability of trauma coding was calculated using Cohen's kappa. The data were recorded in a checklist, in which the validity of the content had been confirmed by experts. RESULTS The reliability of the coding related to the nature of trauma in research units was 0.75-0.77, indicating moderate reliability. Also, the reliability of the coding of external causes of trauma was 0.57-0.58, suggesting poor reliability. CONCLUSION The reliability of trauma coding both in terms of the nature of trauma and the external causes of trauma does not have a good status in the research units. This can be due to the complex coding of trauma, poor documentation of the cases, and not studying the entire case. Therefore, holding training courses for coders, offering training on the accurate documentation to other service providers, and periodically auditing the medical coding are recommended.
Collapse
|
12
|
Stylianou AM, Nikolova K, Ebright E, Rodriguez A. Predictors of Family Engagement in Child Post-Traumatic Stress Disorder Screening Following Exposure to Intimate Partner Violence. JOURNAL OF INTERPERSONAL VIOLENCE 2022; 37:NP2012-NP2037. [PMID: 32589488 DOI: 10.1177/0886260520933047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Children's exposure to intimate partner violence (IPV) has numerous negative short- and long-term impacts on children's development, mental health, physical health, and adult functioning. While community-based organizations have an array of interventions aimed to increase survivor safety and prevent the development of, or treat post-traumatic stress disorder (PTSD), many families experiencing IPV never enter the doors of community-based organizations. To address this gap, there is an increasing number of partnerships between community-based organizations and first responders to increase support to families experiencing IPV. The Child Trauma Response Team (CTRT) is an innovative model that provides a coordinated, immediate, trauma-informed, and interdisciplinary response to families exposed to IPV. Given the lack of research on coordinated community interventions, the research questions for this study were as follows: (a) What are the family sociodemographic factors, crime factors, and program services most associated with family engagement in child PTSD screening following exposure to IPV? (b) What are the family sociodemographic factors and crime factors most associated with children screening positive for PTSD following exposure to IPV? The data for this study consist of 244 families with 352 children identified by the pilot CTRT. The results of this study suggest that a collaborative intervention designed to address caregiver and children's safety and well-being after a police-reported IPV incident is a promising model. Overall, more than 70% of children identified by the CTRT team completed a child PTSD screen, and 74.3% of children who completed the screens were screened positive for PTSD. The safety assessment service provided by the CTRT team was a predictor of the families' engagement in child PTSD screens. This is a critical finding and suggests the importance of developing program models that comprehensively address the needs of caregivers and children exposed to IPV.
Collapse
|
13
|
Siller L, Edwards KM, Banyard V. Violence Typologies Among Youth: A Latent Class Analysis of Middle and High School Youth. JOURNAL OF INTERPERSONAL VIOLENCE 2022; 37:1023-1048. [PMID: 32438882 DOI: 10.1177/0886260520922362] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
Research documents high rates of interpersonal violence (e.g., bullying, dating violence, sexual assault) among middle and high school youth, during which time dating and sexual relationships are emerging. Most research to date focuses on one type of violence at a time or examines the co-occurrence of violence within an age group. This study examined interpersonal violence victimization and perpetration (IVVP) within the context of middle and high school with data from 738 middle school students and 1,311 high school students. Results show distinct classes, or groups, of IVVP among middle and high school students. Three classes emerged for the middle school sample and included a normative class (66.8%; n = 493), a victim of bullying class (28.1%; n = 207), and a mixed/poly-victim class (5.2%; n = 38). Five classes emerged for the high school sample and included a normative class (66.7%; n = 975), a victim of bullying class (18.1%; n = 237), a homophobic bully-victim class (11.0%; n = 144), a poly-victim class (3.1%; n = 40), and a sexual assault perpetrator class (1.1%; n = 15). Demographic and adjustment indicators differentiated many of the classes in each age group. The findings illustrate that there are distinct differences between middle and high school student's exposure to and perpetration of violence. Middle school students may be best served by programs that address victimization experiences while high school may be a developmental moment to introduce sexual assault prevention programs.
Collapse
|
14
|
St-Jean M, Closson K, Salway T, Card K, Patterson TL, Hogg RS, Lima VD. Sexual minority status modifies the association between HIV risk behavior and prevalent mood or anxiety disorders in British Columbia, Canada. Soc Psychiatry Psychiatr Epidemiol 2022; 57:207-218. [PMID: 34279694 DOI: 10.1007/s00127-021-02141-6] [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: 10/29/2020] [Accepted: 07/09/2021] [Indexed: 11/29/2022]
Abstract
PURPOSE This study aimed at determining to what extent sexual minority status modifies the association between HIV risk behavior and prevalent mood or anxiety disorder diagnosis in British Columbia (BC), Canada, using a population-based survey. METHODS This analysis was based on the cross-sectional 2013-2014 Canadian Community Health Survey. The sample was restricted to respondents in BC with valid responses to the survey items considered. A multivariable logistic model, where the behavioral HIV risk score exposure was nested into the sexual minority status modifier, estimated the odds of having a prevalent mood or an anxiety disorder. The behavioral HIV risk score (0, 1, 2, ≥ 3) included the following five measures: (1) age at first intercourse < 14 years, (2) condom use during last intercourse, (3) history of sexually transmitted infections, (5) number of sexual partners in the past 12 months (< 4, ≥ 4), and substance use in the past 12 months. RESULTS Of the weighted sample (2,521,252), 97% (95% confidence interval (CI) 97-98) were heterosexual, while 3% (95% CI 2-3) were lesbian, gay, and bisexual (LGB). The prevalence of a mood or anxiety disorder diagnosis was 12% (95% CI 11-13). For every 1-level increment in the behavioral HIV risk score, the adjusted odds ratio of having a prevalent mood or anxiety disorder diagnosis was 1.29 (95% CI 1.03-1.54) for heterosexual respondents and 2.37 (95% CI 1.84-2.90) for LGB respondents. CONCLUSION Sexual minority status modified the relationship between HIV risk behavior and prevalent mood or anxiety disorders, with a stronger association among LGB respondents. Healthcare providers should prioritize integrated care that addresses the intersectionality between sexual risk, substance use, and mood or anxiety disorders.
Collapse
Affiliation(s)
- Martin St-Jean
- British Columbia Centre for Excellence in HIV/AIDS, 608-1081 Burrard Street, Vancouver, BC, V6Z 1Y6, Canada
| | - Kalysha Closson
- British Columbia Centre for Excellence in HIV/AIDS, 608-1081 Burrard Street, Vancouver, BC, V6Z 1Y6, Canada.,School of Population and Public Health, University of British Columbia, Vancouver, Canada
| | - Travis Salway
- Faculty of Health Sciences, Simon Fraser University, Burnaby, Canada.,Division of Clinical Prevention Services, British Columbia Centre for Disease Control, Vancouver, Canada
| | - Kiffer Card
- British Columbia Centre for Excellence in HIV/AIDS, 608-1081 Burrard Street, Vancouver, BC, V6Z 1Y6, Canada.,Faculty of Health Sciences, Simon Fraser University, Burnaby, Canada
| | | | - Robert S Hogg
- British Columbia Centre for Excellence in HIV/AIDS, 608-1081 Burrard Street, Vancouver, BC, V6Z 1Y6, Canada.,Faculty of Health Sciences, Simon Fraser University, Burnaby, Canada
| | - Viviane D Lima
- British Columbia Centre for Excellence in HIV/AIDS, 608-1081 Burrard Street, Vancouver, BC, V6Z 1Y6, Canada. .,Division of Infectious Diseases, Department of Medicine, Faculty of Medicine, University of British Columbia, Vancouver, Canada.
| |
Collapse
|
15
|
Grimbergen C, Fassaert T. Occurrence of Psychiatric Disorders, Self-Sufficiency Problems and Adverse Childhood Experiences in a Population Suspected of Violent Extremism. Front Psychiatry 2022; 13:779714. [PMID: 35242062 PMCID: PMC8887564 DOI: 10.3389/fpsyt.2022.779714] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2021] [Accepted: 01/20/2022] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Public health-inspired programs for Countering Violent Extremism (CVE) have developed internationally in a relatively short period of time. Research into these programs is scarce. There is a need for information that helps drive public health interventions. OBJECTIVES To present data on the occurrence of psychiatric disorders, self-sufficiency problems and adverse childhood experiences (ACE) in a population suspected of violent extremism. METHODS A cross-sectional study, with data from screening reports for 34 adult subjects included in a multi-agency case-based approach on violent extremism in Amsterdam, the Netherlands. Subjects were screened in the period between December 2015 to May 2021. Screening reports, which included the Screener for Intelligence and Learning Disabilities (SCIL) and the Dutch version of the Self-sufficiency Matrix (SSM-D), were used to gather information on the main outcome measures. RESULTS Major psychiatric disease categories were found to be mood and anxiety disorders and mild intellectual disability (each 29.4%), substance related disorders (35.3%), personality disorders (41.2%), and psychotic disorders (14.7%). Complex self-sufficiency problems, measured by the number of people who had self-sufficiency problems in 4+ domains and the number of people who had similar self-sufficiency problems as homeless people in Amsterdam, were found in 35.3 and 32.4% of the client sample. The most prevalent ACE were emotional neglect (47.1%), household mental illness (44.1%), and loss of a parent (38.2%), 35.3% had been exposed to 4+ ACE. An association was found between NACE and self-sufficiency problems on two domains, namely "Mental Health" (rho = 0.51, p = 0.002) and "Law and order" (rho = 0.42, p = 0.013). CONCLUSIONS An accumulation of social and psychiatric problems in people suspected of violent extremism underlines the importance of professionals in health and social care being actively involved in developing CVE approaches.
Collapse
Affiliation(s)
| | - Thijs Fassaert
- Public Health Service, Amsterdam, Netherlands.,Department of Child and Adolescent Psychiatry and Psychosocial Care, Amsterdam UMC, Amsterdam, Netherlands
| |
Collapse
|
16
|
Panagou C, MacBeth A. Deconstructing pathways to resilience: A systematic review of associations between psychosocial mechanisms and transdiagnostic adult mental health outcomes in the context of adverse childhood experiences. Clin Psychol Psychother 2022; 29:1626-1654. [PMID: 35266603 PMCID: PMC9790303 DOI: 10.1002/cpp.2732] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2021] [Revised: 03/02/2022] [Accepted: 03/07/2022] [Indexed: 12/30/2022]
Abstract
Adverse childhood experiences (ACEs) are identified with increased risk of adult mental health difficulties and negative impacts on well-being. However, there is a need to go beyond simple associations and identify candidate mechanisms underpinning the ACEs-mental health relationship. Further methodological heterogeneity points to issues around the operationalization of ACEs and the importance of modelling data using robust research designs. The aim of the current review was to synthesize studies that utilized formal mediation and/or moderation analyses to explore psychological and social variables on the pathway between clearly defined ACEs (as measured by the ACE questionnaire and Childhood Trauma Questionnaire [CTQ]) and common mental health outcomes (depressive, anxiety and post-traumatic stress disorder [PTSD] symptoms) across community samples aged over 18. A total of 31 papers were retrieved for critical appraisal. The majority of the studies explored factors mediating/moderating the link between child adversity and depression and less on anxiety and trauma. Most mechanisms were tested in only single studies, limiting the consistency of evidence. Evidence indicated that the mechanisms underlying associations between ACEs and adult mental health are likely to reflect multiple intervening variables. Further, there are substantial methodological limitations in the extant literature including the proliferation of causal inferences from cross-sectional designs and both measurement and conceptual issues in operationalizing adversity. Consistent transdiagnostic mechanisms relevant to common mental health problems were identified, including perceived social support, emotion regulation and negative cognitive appraisals/beliefs. Further research using longitudinal design is required to delineate the potential contribution of the identified mechanisms.
Collapse
Affiliation(s)
- Corinna Panagou
- School of Health in Social ScienceUniversity of EdinburghEdinburghEH8 9AGUK
| | - Angus MacBeth
- School of Health in Social ScienceUniversity of EdinburghEdinburghEH8 9AGUK
| |
Collapse
|
17
|
Askenazy F, Fernandez A, Altan L, Battista M, Dückers M, Gindt M, Nachon O, Ivankovic A, Porcar-Becker I, Prieto N, Robert P, Stene LE, Thummler S, Manera V. Remote training as a common tool for the different professionals involved in the acute phase after terror attacks across Europe: Perspectives from an expert panel. Front Psychiatry 2022; 13:915929. [PMID: 36081462 PMCID: PMC9445156 DOI: 10.3389/fpsyt.2022.915929] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Accepted: 08/01/2022] [Indexed: 11/13/2022] Open
Abstract
The acute response after a terror attack may have a crucial impact on the physical and psychological wellbeing of the victims. Preparedness of the professionals involved in the acute response is a key element to ensure effective interventions, and can be improved through trainings. Today in Europe there is a recognized lack of inter-professional and international trainings, which are important, among others, to respond to the needs and the rights of victims affected by a terrorist attack in another country than their home country. In this paper we report the perspectives of an expert panel composed by different categories of professionals on the possible role of interprofessional trainings provided remotely. The experts discussed the pertinence of remote trainings for professionals involved in the acute response of a terror attack, and highlighted their Strengths, Weaknesses, Opportunities and Threats (SWOT analysis). We concluded that, while remote trainings cannot replace in-person trainings, they may be useful to share knowledge about the role and the organization of the different categories of professionals, thus potentially improving response coordination, and to easily share good practices across professionals and countries.
Collapse
Affiliation(s)
- Florence Askenazy
- Cognition Behaviour Technology (CoBTeK) Lab, Université Côte d'Azur, Nice, France.,University Department of Child and Adolescent Psychiatry, Children's Hospitals of Nice CHU-Lenval, Nice, France
| | - Arnaud Fernandez
- Cognition Behaviour Technology (CoBTeK) Lab, Université Côte d'Azur, Nice, France.,University Department of Child and Adolescent Psychiatry, Children's Hospitals of Nice CHU-Lenval, Nice, France
| | | | - Michèle Battista
- University Department of Child and Adolescent Psychiatry, Children's Hospitals of Nice CHU-Lenval, Nice, France
| | - Michel Dückers
- ARQ Centre of Expertise for the Impact of Disasters and Crises, Diemen, Netherlands.,Nivel-Netherlands Institute for Health Services Research, Utrecht, Netherlands.,Faculty of Behavioural and Social Sciences, University of Groningen, Groningen, Netherlands
| | - Morgane Gindt
- Cognition Behaviour Technology (CoBTeK) Lab, Université Côte d'Azur, Nice, France.,University Department of Child and Adolescent Psychiatry, Children's Hospitals of Nice CHU-Lenval, Nice, France
| | - Ophélie Nachon
- Cognition Behaviour Technology (CoBTeK) Lab, Université Côte d'Azur, Nice, France.,University Department of Child and Adolescent Psychiatry, Children's Hospitals of Nice CHU-Lenval, Nice, France
| | | | - Ingeborg Porcar-Becker
- Unit for Trauma, Crisis and Conflicts at the Autonomous University of Barcelona (UAB), Cerdanyola del Vallès, Spain
| | - Nathalie Prieto
- Cellule d'Urgence Médico-Psychologique, Centre Régional du Psychotraumatisme, Hôpital Edouard Herriot, Lyon, France
| | - Philippe Robert
- Cognition Behaviour Technology (CoBTeK) Lab, Université Côte d'Azur, Nice, France.,Association Innovation Alzheimer, Nice, France
| | - Lise Eilin Stene
- Norwegian Centre for Violence and Traumatic Stress Studies (NKVTS), Oslo, Norway
| | - Susanne Thummler
- Cognition Behaviour Technology (CoBTeK) Lab, Université Côte d'Azur, Nice, France.,University Department of Child and Adolescent Psychiatry, Children's Hospitals of Nice CHU-Lenval, Nice, France
| | - Valeria Manera
- Cognition Behaviour Technology (CoBTeK) Lab, Université Côte d'Azur, Nice, France.,Association Innovation Alzheimer, Nice, France
| |
Collapse
|
18
|
Choi YJ, Won MR, Cho DH. Efficacy of a Community-Based Trauma Recovery Program after a Fire Disaster. INTERNATIONAL JOURNAL OF MENTAL HEALTH PROMOTION 2022. [DOI: 10.32604/ijmhp.2022.018017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/06/2023]
|
19
|
van Steijn ME, Scheepstra KWF, Zaat TR, van Rooijen DE, Stramrood CAI, Dijksman LM, Valkenburg-van den Berg AW, Wiltenburg W, van der Post JAM, Olff M, van Pampus MG. Severe postpartum hemorrhage increases risk of posttraumatic stress disorder: a prospective cohort study. J Psychosom Obstet Gynaecol 2021; 42:335-345. [PMID: 32180491 DOI: 10.1080/0167482x.2020.1735343] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
Abstract
PURPOSE To evaluate whether severe postpartum hemorrhage (PPH) is a risk factor for posttraumatic stress disorder (PTSD). Severe PPH can be experienced as a traumatic event. PTSD leads to negative mental health effects. Knowing risk factors for PTSD during childbirth offers opportunities for early interventions, which may prevent the development of PTSD. MATERIALS AND METHODS In this prospective study, we compared two groups of participants; women with ≥2000 mL of blood loss (severe PPH, patients) and women with ≤500 mL of blood loss (controls). Participants were screened for PTSD using the PCL-5 four to six weeks after delivery. Positive screening was followed by the CAPS-5 to diagnose PTSD. RESULTS We included 187 PPH patients and 121 controls. Median PCL-5 scores were higher for PPH patients (5.0) than controls (4.0, p = 0.005). Thirteen PPH patients (7.0%) and two controls (1.7%) scored ≥32 on the PCL-5, indicative of probable PTSD (OR 4.45, 95% CI 0.99-20.06, p = 0.035). Significant more PPH patients than controls met criteria for a clinical diagnosis of PTSD on the CAPS-5 (n = 10, 5.6% vs n = 0, 0.0%; p = 0.007). CONCLUSIONS There is a significant and clinically relevant increased risk for developing PTSD after severe PPH. Gynecologists and midwives are advised to screen for PTSD at postpartum follow-up visits to prevent long-term negative mental health effects. CLINICAL TRIAL REGISTRATION NL50273.100.14.
Collapse
Affiliation(s)
- Minouk E van Steijn
- Department of Obstetrics and Gynecology, OLVG, Amsterdam, the Netherlands.,Department of Obstetrics and Gynecology, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands
| | - Karel W F Scheepstra
- Department of Psychiatry, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands
| | - Tjitske R Zaat
- Department of Obstetrics and Gynecology, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands
| | | | - Claire A I Stramrood
- Department of Obstetrics and Gynecology, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Lea M Dijksman
- Department of Epidemiology and Statistics, St Antonius Hospital, the Netherlands
| | | | - Welmoed Wiltenburg
- Department of Obstetrics and Gynecology, Westfriesgasthuis, the Netherlands
| | - Joris A M van der Post
- Department of Obstetrics and Gynecology, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands
| | - Miranda Olff
- Department of Psychiatry, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands.,Arq Psychotrauma Expert Group, Diemen, The Netherlands
| | - Maria G van Pampus
- Department of Obstetrics and Gynecology, OLVG, Amsterdam, the Netherlands
| |
Collapse
|
20
|
Responding to the Psychological Needs of Health-Care Workers During the COVID-19 Pandemic: Case Study from the Medical College of Wisconsin. J Clin Psychol Med Settings 2021; 29:150-161. [PMID: 34059975 PMCID: PMC8166374 DOI: 10.1007/s10880-021-09791-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/22/2021] [Indexed: 12/19/2022]
Abstract
With the advent of the novel coronavirus (COVID-19) pandemic, health-care workers have been faced with an inordinately high level of trauma as frontline providers. The Medical College of Wisconsin (MCW) partnered with affiliate hospitals and community partners to mobilize a matrix of available support and interventions to deliver psychological services to reach all levels of health-care providers in timely, accessible formats. While virtual peer support groups were the most utilized resource among the support group options, other opportunities also provided unique benefits to learners whose education had been disrupted by the pandemic. Mental health must be prioritized for health-care workers in the event of future public health crises. Lessons learned from this pandemic indicate that it is critical to involve learners early on in the process in order to meet their educational needs and to increase access to evidence-based care.
Collapse
|
21
|
Bisson JI, Wright LA, Jones KA, Lewis C, Phelps AJ, Sijbrandij M, Varker T, Roberts NP. Preventing the onset of post traumatic stress disorder. Clin Psychol Rev 2021; 86:102004. [PMID: 33857763 DOI: 10.1016/j.cpr.2021.102004] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Revised: 01/25/2021] [Accepted: 02/26/2021] [Indexed: 12/15/2022]
Abstract
Post-traumatic stress disorder (PTSD) is a common mental health condition that requires exposure to a traumatic event. This provides unique opportunities for prevention that are not available for other disorders. The aim of this review was to undertake a systematic review and evaluation of randomized controlled trials (RCTs) of interventions designed to prevent PTSD in adults. Searches involving Cochrane, Embase, Medline, PsycINFO, PILOTS and Pubmed databases were undertaken to identify RCTs of pre-incident preparedness and post-incident interventions until May 2019. Six pre-incident and 69 post-incident trials were identified that could be included in meta-analyses. The overall quality of the evidence was low. There was emerging evidence that some interventions may be helpful but an absence of evidence for any intervention that can be strongly recommended for universal, selected or indicated prevention before or within the first three months of a traumatic event. The strongest results were found for cognitive-behavioural therapy with a trauma focus (CBT-T) in individuals with a diagnosis of acute stress disorder which supports calls to detect and treat individuals with significant symptoms rather than providing blanket preventative interventions. Further research is required to optimally configure existing interventions with some evidence of effect and to develop novel interventions to address this major public health issue.
Collapse
Affiliation(s)
- Jonathan I Bisson
- Division of Psychological Medicine and Clinical Neurosciences, Cardiff University School of Medicine, United Kingdom.
| | - Laurence Astill Wright
- Division of Psychological Medicine and Clinical Neurosciences, Cardiff University School of Medicine, United Kingdom
| | - Kimberley A Jones
- Phoenix Australia- Centre for Posttraumatic Mental Health, Department of Psychiatry, University of Melbourne, Carlton, Victoria, Australia
| | - Catrin Lewis
- Division of Psychological Medicine and Clinical Neurosciences, Cardiff University School of Medicine, United Kingdom
| | - Andrea J Phelps
- Phoenix Australia- Centre for Posttraumatic Mental Health, Department of Psychiatry, University of Melbourne, Carlton, Victoria, Australia
| | - Marit Sijbrandij
- Department of Clinical, Neuro- and Developmental Psychology, World Health Organization Collaborating Centre for Research and Dissemination of Psychological Interventions, VU University, Amsterdam, the Netherlands
| | - Tracey Varker
- Phoenix Australia- Centre for Posttraumatic Mental Health, Department of Psychiatry, University of Melbourne, Carlton, Victoria, Australia
| | - Neil P Roberts
- Psychology and Psychological Therapies Directorate, Cardiff & Vale University Health Board, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University School of Medicine, United Kingdom
| |
Collapse
|
22
|
Kimiafar K, Farrokhi M, Manouchehri Monazah F, Khadem-Rezaiyan M, Sarbaz M. Fall-related hospitalization of patients in Iran. Chin J Traumatol 2021; 24:115-119. [PMID: 33622588 PMCID: PMC8071714 DOI: 10.1016/j.cjtee.2021.01.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Revised: 01/01/2021] [Accepted: 01/05/2021] [Indexed: 02/04/2023] Open
Abstract
PURPOSE Trauma has been called the neglected disease of modern society. According to WHO, fall is the second major cause of trauma or deaths resulting from unintentional accidents. The aim of this study was to investigate the different types of fall according to International Statistical Classification of Diseases and Related Health Problems 10th Revision (ICD-10) in hospitalized patients visiting specialized accident and trauma hospitals of Mashhad, Iran. METHODS This was a cross sectional retrospective study performed between March 20, 2013 and March 20, 2014. The research population consisted of all medical records of patients for fall injuries in three specialized accident and trauma hospitals. ICD-10 was adopted to categorize all types of falls (w00-w19). The results obtained were analyzed by SPSS 16. RESULTS Altogether 7,448 cases were included. The codes w18 (fall on same level) and w09 (fall involving playground equipment) with the frequencies of 1,856 and 1,303, respectively in both genders had the maximum number of falls. The maximum percentage of mortality has been related to "fall on and from ladder"," fall from cliff "and "fall on same level involving ice and snow". CONCLUSION As falls can cause irrecoverable injuries including mortality of people, thus health authorities and policymakers should take preventive measures given the causes of falls and the root of this type of injuries, so that the costs resulting from this cause and its injuries can be reduced.
Collapse
Affiliation(s)
- Khalil Kimiafar
- Department of Medical Records and Health Information Technology, School of Paramedical Sciences, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Maryam Farrokhi
- Department of Medical Informatics, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Fereshte Manouchehri Monazah
- Department of Medical Records and Health Information Technology, School of Paramedical Sciences, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Majid Khadem-Rezaiyan
- Department of Community Medicine and Public Health, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Masoumeh Sarbaz
- Department of Medical Records and Health Information Technology, School of Paramedical Sciences, Mashhad University of Medical Sciences, Mashhad, Iran,Corresponding author.
| |
Collapse
|
23
|
Bower KM, Alexander KA, Levin MB, Jaques KA, Kub J. Using Critical Service-Learning Pedagogy to Prepare Graduate Nurses to Promote Health Equity. J Nurs Educ 2021; 60:38-43. [PMID: 33400807 DOI: 10.3928/01484834-20201217-09] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2020] [Accepted: 07/15/2020] [Indexed: 11/20/2022]
Abstract
BACKGROUND Despite calls from professional organizations to prepare a nursing workforce with the requisite skills to address social determinants of health (SDOH), there is little guidance for nurse educators about how to actively promote student learning of these complex issues. METHOD We applied a critical service-learning (CSL) pedagogy to enhance graduate public health nursing curriculum and support learner skill building in approaches to combat health disparities by addressing the underlying social conditions. RESULTS Course content and critical reflection activities were built incrementally across four courses and semesters to introduce and apply antioppressive frameworks, encourage students to examine their personal identities of privilege and oppression, and examine historical context and systems of power in public health settings. CONCLUSION CSL supports student development of structural competence and their understanding of approaches that can dismantle inequitable systems by addressing SDOH that contribute to health disparities. [J Nurs Educ. 2021;60(1):38-43.].
Collapse
|
24
|
Abstract
E-health offers great potential in the field of traumatic stress to deliver training, assessment, prevention, and treatment of adverse outcomes after trauma worldwide. In order to encourage research on E-health applications in the field of traumatic stress, this current special issue of the European Journal of Psychotraumatology presents a series of papers divided into three emergent topics: I) development of digital interventions, II) the use of digital interventions to foster self-management and deliver therapy, and III) digital methods to improve prediction, assessment, and monitoring of post-trauma outcomes. These studies show acceptance of the tools by various end-user groups and improvements of current research and clinical practices, but also areas for improvement regarding the development process and making even better use of technological capabilities of E-Health. We propose three general themes to accelerate the quality of e-Health interventions and studies in this area in the coming years: optimizing user engagement and adherence, conducting more (innovative) research, and increasing implementation and dissemination activities. This issue appears in the midst of the COVID-19 pandemic. It is exactly at times like these that we need effective online interventions and we see an enormous increase in the use of e-Health. We hope this issue will contribute to help those affected and to serve the community worldwide.
Collapse
Affiliation(s)
- Anne Bakker
- Department of Psychiatry, Amsterdam Public Health Research Institute, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
| | - Heleen Riper
- Clinical, Neuro and Developmental Psychology, Vrije Universiteit Amsterdam (VU), Amsterdam, the Netherlands
| | - Miranda Olff
- Department of Psychiatry, Amsterdam Neuroscience Research Institute & Amsterdam Public Health Research Institute, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands.,ARQ National Psychotrauma Centre, Diemen, the Netherlands
| |
Collapse
|
25
|
Abstract
OBJECTIVES Exposures to adverse events are associated with impaired later-life psychological health. While these associations depend on the type of event, the manner in which associations for different event types depend on when they occur within the life course has received less attention. We investigated associations between counts of adverse events over the life course, and wellbeing and mental health outcomes in older people, according to their timing (age of occurrence), orientation (self or other) and, both their timing and orientation. DESIGN Linear and logistic random-effects models for repeated observations. SETTING England, 2002-2015. PARTICIPANTS A total of 4,208 respondents aged >50 years with 22,146 observations across Waves 1-7 of the English Longitudinal Study of Ageing. MEASUREMENTS Cumulative adversity was measured by counts of 16 types of events occurring within four age ranges over the life course using retrospective life history data. These were categorized into other- (experienced through harms to others) and self-oriented events. Outcomes included CASP-12 (control, autonomy, self-realization, and pleasure), the eight-item Centre of Epidemiological Studies Depression Scale, and self-appraised subjective life satisfaction. RESULTS Additional adverse events were associated with lower CASP-12 and life satisfaction scores, and higher odds of probable depressive caseness. In childhood, other-oriented events had a larger negative association with later-life wellbeing than self-oriented events; the converse was found for events occurring in adulthood. CONCLUSIONS Events occurring at all life course stages were independently associated with both later-life wellbeing and depression in a cumulative fashion. Certain age ranges may represent sensitive periods for specific event types.
Collapse
|
26
|
Dias A, Mooren T, Kleber RJ. Reducing consequences of child maltreatment during adulthood by public health actions: a Delphi study. Eur J Public Health 2020; 29:425-431. [PMID: 30312403 DOI: 10.1093/eurpub/cky216] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Child maltreatment (CM) is associated with long-lasting poor health outcomes, as well as increased levels of disability and health-services consumption across the life-span. However, less is known about how CM consequences can be reduced during adulthood. We investigated professional opinions on how to mitigate long-term consequences of CM in a public health (PH) perspective. METHODS Using the Delphi method in three rounds, we inquired 91 professionals, mostly European researchers and clinicians about potential PH actions to mitigate CM consequences during adulthood. RESULTS Most experts agreed that PH actions are needed. Increasing community awareness and training emotional regulation in affected adults were prioritized strategies. Enlarging curricular knowledge about CM for professionals and developing evidence-based interventions were considered preferred methods. Reducing the barriers for access to interventions for adults, such as those provided by trauma-informed services were also suggested. Participants highlighted the possibility to reduce CM consequences across generations as a significant benefit. CONCLUSIONS PH programmes to reduce the burden of CM can be enhanced by specific actions to facilitate the recognition of difficulties in affected adults and to expand the availability of helpful resources. The application of these programmes could be assisted by the use of modern information-technology.
Collapse
Affiliation(s)
- Aida Dias
- Department of Clinical Psychology, Utrecht University, Utrecht, The Netherlands.,Centro de Trauma, CES, University of Coimbra, Coimbra, Portugal
| | - Trudy Mooren
- Department of Clinical Psychology, Utrecht University, Utrecht, The Netherlands.,Arq Psychotrauma Expert Group, Diemen, The Netherlands
| | - Rolf J Kleber
- Department of Clinical Psychology, Utrecht University, Utrecht, The Netherlands.,Arq Psychotrauma Expert Group, Diemen, The Netherlands
| |
Collapse
|
27
|
Woods-Jaeger B, Siedlik E, Adams A, Piper K, O'Connor P, Berkley-Patton J. Building a Contextually-Relevant Understanding of Resilience among African American Youth Exposed to Community Violence. Behav Med 2020; 46:330-339. [PMID: 32787725 DOI: 10.1080/08964289.2020.1725865] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Studies consistently demonstrate that African American youth experience disproportionate levels of community violence, which is associated with negative health and well-being outcomes among these youth. The frequency and severity of community violence exposure is a unique challenge for these youth and requires tailored approaches to promote resilience after community violence exposure. However, limited research exists that operationalizes resilience after community violence based on the unique context and lived experience of African American youth. Developing a more contextually relevant understanding of resilience is critical to reducing health inequities experienced by African American youth and promoting their well-being. Five focus groups were conducted with 39 African American adolescents (ages 13-18) exposed to community violence. Participants also completed a brief survey that included questions on demographics, adverse childhood experiences, social capital, and resilience. Focus-group transcripts were independently coded by two members of the research team and analyzed using an inductive approach. Youth highlighted key indicators of resilience including the ability to persevere, self-regulate, and change to adapt/improve. Youth also described family, peer, and cultural contexts that impact how resilience is produced and manifested, highlighting trust, perceived burdensomeness, self-determination, connectedness, and mental health stigma as key factors within these contexts. Results of this qualitative study support the development of health promotion programs for African American youth exposed to community violence that address unique risks and build on existing protective factors within family, peer, and cultural contexts.
Collapse
|
28
|
Denckla CA, Gelaye B, Orlinsky L, Koenen KC. REACH for mental health in the COVID19 pandemic: an urgent call for public health action. Eur J Psychotraumatol 2020; 11:1762995. [PMID: 33029305 PMCID: PMC7473288 DOI: 10.1080/20008198.2020.1762995] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
Our submission is responsive to the urgent need for public mental health action prompted by the escalating COVID-19 pandemic. In it, we review the evidence calling for urgent public mental health action, propose a mental health equivalent fo the World Health Organization's 'Do the Five' concept, and describe the 'REACH for Mental Health' public health measure we have launched at the Harvard T.H. Chan School of Public Health.
Collapse
Affiliation(s)
- Christy A Denckla
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Bizu Gelaye
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Leah Orlinsky
- Yale Center for Emotional Intelligence, Yale University, New Haven, CT, USA
| | - Karestan C Koenen
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| |
Collapse
|
29
|
Champine RB, Lang JM, Nelson AM, Hanson RF, Tebes JK. Systems Measures of a Trauma-Informed Approach: A Systematic Review. AMERICAN JOURNAL OF COMMUNITY PSYCHOLOGY 2019; 64:418-437. [PMID: 31469452 PMCID: PMC7003149 DOI: 10.1002/ajcp.12388] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Abstract
Interest in trauma-informed approaches has grown substantially. These approaches are characterized by integrating understanding of trauma throughout a program, organization, or system to enhance the quality, effectiveness, and delivery of services provided to individuals and groups. However, variation in definitions of trauma-informed approaches, coupled with underdeveloped research on measurement, poses challenges for evaluating the effectiveness of models designed to support a trauma-informed approach. This systematic review of peer-reviewed and gray literature identified 49 systems-based measures that were created to assess the extent to which relational, organizational, and community/system practices were trauma-informed. Measures were included if they assessed at least one component of a trauma-informed approach, were not screening or diagnostic instruments, were standardized, were relevant to practices addressing the psychological impacts of trauma, were printed in English, and were published between 1988 and 2018. Most (77.6%) measures assessed organizational-level staff and climate characteristics. There remain several challenges to this emerging field, including inconsistently reported psychometric data, redundancy across measures, insufficient evidence of a link to stakeholder outcomes, and limited information about measurement development processes. We discuss these opportunities and challenges and their implications for future research and practice.
Collapse
Affiliation(s)
- Robey B. Champine
- Child Health and Development Institute of Connecticut,
Farmington, CT 06032
- Yale School of Medicine, Division of Prevention and
Community Research, New Haven, CT 06511
- Michigan State University, College of Human Medicine,
Division of Public Health, Flint, MI 48502
| | - Jason M. Lang
- Child Health and Development Institute of Connecticut,
Farmington, CT 06032
- UCONN Health, Department of Psychiatry, Farmington, CT
06032
- Child Study Center, Yale Schools of Medicine, New Haven, CT
06511
| | - Ashley M. Nelson
- Child Health and Development Institute of Connecticut,
Farmington, CT 06032
| | - Rochelle F. Hanson
- Medical University of South Carolina, Department of
Psychiatry and Behavioral Sciences, Charleston, SC 29425
| | - Jacob K. Tebes
- Yale School of Medicine, Division of Prevention and
Community Research, New Haven, CT 06511
- Yale School of Public Health, New Haven, CT 06511
| |
Collapse
|
30
|
Tebes JK, Champine RB, Matlin SL, Strambler MJ. Population Health and Trauma-Informed Practice: Implications for Programs, Systems, and Policies. AMERICAN JOURNAL OF COMMUNITY PSYCHOLOGY 2019; 64:494-508. [PMID: 31444915 PMCID: PMC7006880 DOI: 10.1002/ajcp.12382] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/20/2023]
Abstract
Population studies indicate that trauma exposure is ubiquitous and has a significant impact on health. Trauma-informed practice seeks to address the health consequences of trauma through integrative responses that incorporate an understanding of the effects of trauma, the multiple pathways to recovery, and the potential for re-traumatization. Current trauma-informed practice considers trauma exposure an individual clinical problem rather than a societal problem with population health consequences. Population health refers to the aggregated health status of individuals who share some characteristic, such as trauma exposure, and includes the study of determinants that shape the distribution of health outcomes in specific populations. In this paper, we describe a population health perspective for trauma-informed practice that complements the current clinical perspective, and then discuss implications of that perspective for programs, systems, and policies. We summarize essential concepts about trauma over the life course and describe principles of population health science relevant to trauma-informed practice. We then discuss implications of these principles by identifying four priorities for trauma-informed practice from a population health perspective: (a) adopting trauma-informed policies to prevent trauma exposure and to foster resilience in the aftermath of trauma; (b) infusing trauma-informed practice into everyday activities so it is a routine part of interpersonal transactions; (c) incorporating trauma-informed practices into existing service systems; and (d) adapting existing treatments to incorporate trauma-informed principles for population health impact.
Collapse
Affiliation(s)
| | - Robey B Champine
- Yale School of Medicine, New Haven, CT, USA
- Child Health & Development Institute, Inc., Farmington, CT, USA
| | - Samantha L Matlin
- Yale School of Medicine, New Haven, CT, USA
- The Scattergood Foundation, Philadelphia, PA, USA
| | | |
Collapse
|
31
|
Matlin SL, Champine RB, Strambler MJ, O'Brien C, Hoffman E, Whitson M, Kolka L, Tebes JK. A Community's Response to Adverse Childhood Experiences: Building a Resilient, Trauma-Informed Community. AMERICAN JOURNAL OF COMMUNITY PSYCHOLOGY 2019; 64:451-466. [PMID: 31486086 PMCID: PMC6917911 DOI: 10.1002/ajcp.12386] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/20/2023]
Abstract
Adverse childhood experiences, or ACEs, may be mitigated by trauma-informed social environments-programs, services, systems, communities-that offer responses to trauma that promote healing, recovery, and resilience. However, there is currently little empirical evidence to support the use of specific approaches to do so. Guided by a population health perspective, this paper describes a participatory community change process in response to ACEs that seeks to build a resilient, trauma-informed community in Pottstown, PA. We examine the initial implementation phase of this change process, centered originally on the education sector and the social and behavioral health services sector, and then eventually expanding to 14 community sectors across two years. A variety of data sources and methods are used to track individual and organizational processes, as well as service system network processes. A central feature of this research is the use of data to generate hypotheses rather than test them. Data were also used to guide understanding and decision-making during implementation. The results show that moving forward the community is well-positioned to establish stronger inter-agency and system supports for trauma-informed practice in the service system and in the broader community. We discuss results for their implications for building resilient, trauma-informed communities.
Collapse
Affiliation(s)
- Samantha L Matlin
- The Scattergood Foundation and Yale School of Medicine, Philadelphia, PA, USA
| | - Robey B Champine
- Yale School of Medicine & Child Health & Development Institute, New Haven, CT, USA
| | | | | | | | | | - Laurie Kolka
- Pottstown School District & Pottstown Trauma-Informed Community Connection, Pottstown, PA, USA
| | | |
Collapse
|
32
|
Olff M, Amstadter A, Armour C, Birkeland MS, Bui E, Cloitre M, Ehlers A, Ford JD, Greene T, Hansen M, Lanius R, Roberts N, Rosner R, Thoresen S. A decennial review of psychotraumatology: what did we learn and where are we going? Eur J Psychotraumatol 2019; 10:1672948. [PMID: 31897268 PMCID: PMC6924542 DOI: 10.1080/20008198.2019.1672948] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/24/2023] Open
Abstract
On 6 December 2019 we start the 10th year of the European Journal of Psychotraumatogy (EJPT), a full Open Access journal on psychotrauma. This editorial is part of a special issue/collection celebrating the 10 years anniversary of the journal where we will acknowledge some of our most impactful articles of the past decade (also discussed below and marked with * in the reference list). In this editorial the editors present a decennial review of the field addressing a range of topics that are core to both the journal and to psychotraumatology as a discipline. These include neurobiological developments (genomics, neuroimaging and neuroendocrine research), forms of trauma exposure and impact across the lifespan, mass trauma and early interventions, work-related trauma, trauma in refugee populations, and the potential consequences of trauma such as PTSD or Complex PTSD, but also resilience. We address innovations in psychological, medication (enhanced) and technology-assisted treatments, mediators and moderators like social support and finally how new research methods help us to gain insights in symptom structures or to better predict symptom development or treatment success. We aimed to answer three questions 1. Where did we stand in 2010? 2. What did we learn in the past 10 years? 3. What are our knowledge gaps? We conclude with a number of recommendations concerning top priorities for the future direction of the field of psychotraumatology and correspondingly the journal.
Collapse
Affiliation(s)
- Miranda Olff
- Department of Psychiatry, Amsterdam
University Medical Centers (location AMC), University of Amsterdam, Amsterdam
Neuroscience, Amsterdam, The Netherlands
- ARQ National Psychotrauma
Centre, Diemen, The Netherlands
| | - Ananda Amstadter
- Departemnts of Psychiatry, Psychology, &
Human and Molecular Genetics, Virginia Commonwealth University, Richmond,
USA
| | - Cherie Armour
- School of Psychology, Queens University
Belfast, Belfast, Northern Ireland, UK
| | - Marianne S. Birkeland
- Section for implementation and treatment
research, Norwegian Centre for Violence and Traumatic Stress Studies, Oslo
Norway
| | - Eric Bui
- Department of Psychiatry, Massachusetts
General Hospital & Harvard Medical School, Boston, MA,
USA
| | - Marylene Cloitre
- National Center for PTSD Dissemination and
Training Division, Palo Alto, CA, USA
- Department of Psychiatry and Behavioral
Sciences, Stanford University, Palo Alto, CA, USA
| | - Anke Ehlers
- Department of Experimental Psychology,
University of Oxford, Oxford, UK
| | - Julian D. Ford
- Department of Psychiatry, University of
Connecticut Health Center, Farmington, USA
| | - Talya Greene
- Department of Community Mental Health,
University of Haifa, Haifa, Israel
| | - Maj Hansen
- Department of Psychology,
Odense, Denmark
| | - Ruth Lanius
- Posttraumatic Stress Disorder (PTSD) Research
Unit, Western University of Canada, London, ON,
Canada
| | - Neil Roberts
- Psychology and Psychological Therapies
Directorate, Cardiff & Vale University Health Board, Cardiff,
UK
- Division of Psychological Medicine &
Clinical Neurosciences, Cardiff University, Cardiff,
UK
| | - Rita Rosner
- Department of Clinical and Biological
Psychology, KU Eichstaett-Ingolstadt, Eichstaett,
Germany
| | - Siri Thoresen
- Section for trauma, catastrophes and forced
migration – children and youth, Norwegian Centre for Violence and Traumatic Stress
Studies, Oslo, Norway
| |
Collapse
|
33
|
Hambrick EP, Brawner TW, Perry BD. Timing of Early-Life Stress and the Development of Brain-Related Capacities. Front Behav Neurosci 2019; 13:183. [PMID: 31447660 PMCID: PMC6691036 DOI: 10.3389/fnbeh.2019.00183] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2019] [Accepted: 07/23/2019] [Indexed: 11/25/2022] Open
Abstract
Early-life stress (ELS) poses risks for developmental and mental health problems throughout the lifespan. More research is needed regarding how specific ELS experiences influence specific aspects of neurodevelopment. We examined the association between ELS, defined as severe adversity (e.g., domestic violence, caregiver drug use) and severe relational poverty (e.g., caregiver neglect, lack of caregiver attunement), occurring during the first 2 months of life and a variety of brain-related, clinician-rated functions, including self-regulation and relational capacities. Interdisciplinary clinicians using the Neurosequential Model of Therapeutics (NMT), an approach to clinical problem solving, reported on the timing and type of treatment-seeking children’s (N = 2,155; 8–10 years) stressful experiences during four developmental periods: Perinatal (0–2 months), Infancy (2–12 months), Early Childhood (13 months to 4 years), and Childhood (4–11 years). They also reported on children’s current functioning in 32 brain-related domains (e.g., sleep, arousal, impulsivity, empathy, concrete cognition). Non-negative matrix factorization (NMF) was conducted on the 32 brain-related domains to identify latent factors, yielding four factors comprising Sensory Integration, Self-Regulation, Relational, and Cognitive functioning. Regularized hierarchical models were then used to identify associations between ELS and each latent factor while controlling for stress occurring during subsequent developmental periods, and children’s current degree of relational health. ELS (stress occurring during the first 2 months of life), specifically a severe lack of positive relational experiences (e.g., caregiver neglect, lack of caregiver attunement), was associated with the Sensory Integration and Self-Regulation factors. The Relational factor was better explained by stress occurring during childhood, and the Cognitive factor by stress occurring during infancy and childhood. Implications for how the timing and type of stress experiences may influence brain-related outcomes that are observed in clinical settings are discussed. Future directions include longitudinal follow-ups and greater specification of environmental variables, such as types of interventions received and when they were received, that may interact with ELS experiences to influence brain-related outcomes.
Collapse
Affiliation(s)
- Erin P Hambrick
- The ChildTrauma Academy, Houston, TX, United States.,Lab PANDA, Department of Psychology, University of Missouri-Kansas City, Kansas City, MO, United States
| | - Thomas W Brawner
- The ChildTrauma Academy, Houston, TX, United States.,Center for Research Methods and Data Analysis, University of Kansas, Lawrence, KS, United States
| | - Bruce D Perry
- The ChildTrauma Academy, Houston, TX, United States.,Department of Psychiatry, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States.,School of Allied Health, College of Science, Health and Engineering, La Trobe University, Melbourne, VIC, Australia
| |
Collapse
|
34
|
Yadollahi M. A study of mortality risk factors among trauma referrals to trauma center, Shiraz, Iran, 2017. Chin J Traumatol 2019; 22:212-218. [PMID: 31239216 PMCID: PMC6667929 DOI: 10.1016/j.cjtee.2019.01.012] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2018] [Revised: 10/16/2018] [Accepted: 04/08/2019] [Indexed: 02/04/2023] Open
Abstract
PURPOSE Trauma is well known as one of the main causes of death and disability throughout the world. Identifying the risk factors for mortality in trauma patients can significantly improve the quality of care and patient outcomes, as well as reducing mortality rates. METHODS In this retrospective cohort study, systematic randomization was used to select 849 patients referred to the main trauma center of south of Iran during a period of six months (February 2017-July 2017); the patients' case files were evaluated in terms of demographic information, pre- and post-accident conditions, clinical conditions at the time of admission and finally, accident outcomes. A logistic regression model was used to analyze the role of factors affecting mortality among subjects. RESULTS Among subjects, 60.4% were in the age-group of 15-39 years. There was a 10.4% mortality rate among patients and motor-vehicle accidents were the most common mechanism of injury (66.7%). Aging led to increased risk of fatality in this study. For each unit increase in Glasgow coma scale (GCS), risk of death decreased by about 40% (odds ratio (OR) = 0.63, 95% confidence interval (CI): 0.59-0.67). For each unit increase in injury severe score (ISS), risk of death increased by 10% (OR = 1.11%, 95% CI: 1.08-1.14) and for each unit increase in trauma revised injury severity score (TRISS), there was 18% decrease in the risk of fatality (OR = 0.82, 95% CI: 0.71-0.88). CONCLUSION The most common cause of trauma and the most common cause of death from trauma was traffic accidents. It was also found that an increase in the ISS index increases the risk of death in trauma patients, but the increase in GCS, revised trauma score (RTS) and TRISS indices reduces the risk of death in trauma patients. The TRISS indicator is better predictor of traumatic death than other indicators.
Collapse
Affiliation(s)
- Mahnaz Yadollahi
- Trauma Research Center, Shahid Rajaee (Emtiaz) Trauma Hospital, Shiraz University of Medical Sciences, Shiraz, Iran.
| |
Collapse
|
35
|
Engel S, van Zuiden M, Frijling JL, Koch SBJ, Nawijn L, Schumacher S, Knaevelsrud C, Veltman DJ, Olff M. Patterns of Recovery From Early Posttraumatic Stress Symptoms After a Preventive Intervention With Oxytocin: Hormonal Contraception Use Is a Prognostic Factor. Biol Psychiatry 2019; 85:e71-e73. [PMID: 30824111 DOI: 10.1016/j.biopsych.2019.01.014] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2019] [Accepted: 01/18/2019] [Indexed: 01/22/2023]
Affiliation(s)
- Sinha Engel
- Department of Psychiatry, Amsterdam University Medical Centers, Location Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands; Division of Clinical Psychological Intervention, Freie Universität Berlin, Berlin, Germany
| | - Mirjam van Zuiden
- Department of Psychiatry, Amsterdam University Medical Centers, Location Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands.
| | - Jessie L Frijling
- Department of Psychiatry, Amsterdam University Medical Centers, Location Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands
| | - Saskia B J Koch
- Department of Psychiatry, Amsterdam University Medical Centers, Location Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands; Donders Institute for Brain, Cognition and Behaviour, Centre for Cognitive Neuroimaging, Radboud University Nijmegen, Nijmegen, the Netherlands
| | - Laura Nawijn
- Department of Psychiatry, Amsterdam University Medical Centers, Location Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands; Department of Psychiatry, Amsterdam University Medical Centers, Location VU University Medical Center, VU University, Amsterdam, the Netherlands
| | - Sarah Schumacher
- Division of Clinical Psychological Intervention, Freie Universität Berlin, Berlin, Germany
| | - Christine Knaevelsrud
- Division of Clinical Psychological Intervention, Freie Universität Berlin, Berlin, Germany
| | - Dick J Veltman
- Department of Psychiatry, Amsterdam University Medical Centers, Location VU University Medical Center, VU University, Amsterdam, the Netherlands
| | - Miranda Olff
- Department of Psychiatry, Amsterdam University Medical Centers, Location Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands; Arq Psychotrauma Expert Group, Diemen, the Netherlands
| |
Collapse
|
36
|
Akiki TJ, Averill LA, Abdallah CG. Neurobiological studies of trauma-related psychopathology: a public health perspective. Eur J Psychotraumatol 2018; 9:1556554. [PMID: 30637093 PMCID: PMC6319465 DOI: 10.1080/20008198.2018.1556554] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2018] [Revised: 11/23/2018] [Accepted: 11/28/2018] [Indexed: 01/30/2023] Open
Abstract
The societal burden of psychiatric disorders that result after exposure to psychological trauma is enormous. The study of trauma-related disorders using neurobiological and public health approaches is often disjointed. It is critical to emphasize the translational potential of neurobiological work and its relevance to the public health burden of psychological trauma. Applying a public health model to traumatology that includes primary, secondary, and tertiary levels, we highlight ways in which advancing the field of neurobiology can pave the way for scalable interventions that can improve outcomes and help to address the public health problem.
Collapse
Affiliation(s)
- Teddy J. Akiki
- Clinical Neurosciences Division National Center for PTSD, United States Department of Veterans Affairs, West Haven, CT, USA
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| | - Lynnette A. Averill
- Clinical Neurosciences Division National Center for PTSD, United States Department of Veterans Affairs, West Haven, CT, USA
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| | - Chadi G. Abdallah
- Clinical Neurosciences Division National Center for PTSD, United States Department of Veterans Affairs, West Haven, CT, USA
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| |
Collapse
|
37
|
Baranyi G, Cassidy M, Fazel S, Priebe S, Mundt AP. Prevalence of Posttraumatic Stress Disorder in Prisoners. Epidemiol Rev 2018; 40:134-145. [PMID: 29596582 PMCID: PMC5982805 DOI: 10.1093/epirev/mxx015] [Citation(s) in RCA: 87] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2017] [Accepted: 10/25/2017] [Indexed: 12/13/2022] Open
Abstract
People involved with criminal justice frequently are exposed to violence and traumatic experiences. This may lead to posttraumatic stress disorder (PTSD); however, no review, to our knowledge, has synthetized findings in this setting. We conducted a systematic review and meta-analysis to estimate prevalence rates of PTSD in prison populations. Original studies in which prevalence rates of PTSD in unselected samples of incarcerated people were reported were systematically searched between 1980 and June 2017. Data were pooled using random-effects meta-analysis, and sources of heterogeneity for prespecified characteristics were assessed by meta-regression. We identified 56 samples comprising 21,099 imprisoned men and women from 20 countries. Point prevalence of PTSD ranged from 0.1% to 27% for male, and from 12% to 38% for female prisoner populations. The random-effects pooled point prevalence was 6.2% (95% confidence interval: 3.9, 9.0) in male prisoners and 21.1% (95% confidence interval: 16.9, 25.6) in female prisoners. The heterogeneity between the included studies was very high. Higher prevalence was reported in samples of female prisoners, smaller studies (n < 100), and for investigations based in high-income countries. Existing evidence shows high levels of PTSD among imprisoned people, especially women. Psychosocial interventions to prevent violence, especially against children and women, and to mitigate its consequences in marginalized communities must be improved. Trauma-informed approaches for correctional programs and scalable PTSD treatments in prisons require further consideration.
Collapse
Affiliation(s)
- Gergõ Baranyi
- Center for Research on Environment Society and Health, School of GeoSciences, The University of Edinburgh, Edinburgh, United Kingdom
| | - Megan Cassidy
- Unit for Social and Community Psychiatry, WHO Collaborating Center for Mental Health Services Development, Queen Mary University of London, London, United Kingdom
| | - Seena Fazel
- Department of Psychiatry, University of Oxford, Oxford, United Kingdom
| | - Stefan Priebe
- Unit for Social and Community Psychiatry, WHO Collaborating Center for Mental Health Services Development, Queen Mary University of London, London, United Kingdom
| | - Adrian P Mundt
- Medical Faculty, Universidad Diego Portales, Santiago, Chile.,Medical School, Universidad San Sebastián, Puerto Montt, Chile
| |
Collapse
|
38
|
Slopen N, Roberts AL, LeWinn KZ, Bush NR, Rovnaghi CR, Tylavsky F, Anand KJS. Maternal experiences of trauma and hair cortisol in early childhood in a prospective cohort. Psychoneuroendocrinology 2018; 98:168-176. [PMID: 30170311 DOI: 10.1016/j.psyneuen.2018.08.027] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2018] [Revised: 08/17/2018] [Accepted: 08/20/2018] [Indexed: 12/22/2022]
Abstract
BACKGROUND AND OBJECTIVE Maternal trauma can have intergenerational consequences but little is known about whether maternal traumas affect key biological domains associated with mental health in their offspring. The objective of this study was to examine maternal lifetime history of traumatic events through mid-gestation in relation to offspring cortisol production in early childhood. METHODS The sample was comprised of 660 children (49.9% Black, 44.4% White) from a longitudinal study of mother-offspring dyads in Shelby County, Tennessee, followed from mid-gestation to child age 4 years (enrolled 2006-2011). Maternal lifetime history of traumatic life events were assessed mid-gestation using the Traumatic Life Events Questionnaire. Total cortisol output among offspring was measured using hair cortisol concentrations at ages 1 to 4 years. RESULTS Associations of maternal trauma history with child hair cortisol varied by child's age. No association was observed at age 1 or 2. In adjusted regression models, at ages 3 and 4, offspring of mothers in the third (β = 0.99, P < .01), fourth (β=0.72, P < .05), and fifth (β=0.83, P < .01) quintiles of trauma exposure history had elevated (natural log) hair cortisol concentrations, relative to mothers in the lowest quintile (P-trend = 0.003). The associations were not attenuated after adjustment for theorized pathways, including premature birth, maternal postpartum depression, and maternal parenting stress. CONCLUSIONS Maternal lifetime trauma exposures are associated with offspring hair cortisol concentrations. Future research is needed to determine intermediary mechanisms and functional significance of elevated hair cortisol concentration in young children.
Collapse
Affiliation(s)
- Natalie Slopen
- Department of Epidemiology and Biostatistics, School of Public Health, University of Maryland, College Park, MA, United States.
| | - Andrea L Roberts
- Harvard TH Chan School of Public Health, Boston, MA, United States
| | - Kaja Z LeWinn
- Department of Psychiatry, Weill Institute for Neurosciences, University of California, San Francisco, CA, United States
| | - Nicole R Bush
- Department of Psychiatry, Weill Institute for Neurosciences, University of California, San Francisco, CA, United States; Department of Pediatrics, University of California, San Francisco, CA, United States
| | - Cynthia R Rovnaghi
- Pain/Stress Neurobiology Lab, Child Health Research Institute, Stanford University School of Medicine, Stanford, CA, United States
| | - Frances Tylavsky
- Department of Preventive Medicine, University of Tennessee Health Science Center, Nashville, TN, United States
| | - Kanwaljeet J S Anand
- Department of Pediatrics, Stanford University School of Medicine, Stanford, CA, United States
| |
Collapse
|
39
|
Tebes JK. Team Science, Justice, and the Co-Production of Knowledge. AMERICAN JOURNAL OF COMMUNITY PSYCHOLOGY 2018; 62:13-22. [PMID: 29882968 DOI: 10.1002/ajcp.12252] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/19/2023]
Abstract
Science increasingly consists of interdisciplinary team-based research to address complex social, biomedical, public health, and global challenges through a practice known as team science. In this article, I discuss the added value of team science, including participatory team science, for generating scientific knowledge. Participatory team science involves the inclusion of public stakeholders on science teams as co-producers of knowledge. I also discuss how constructivism offers a common philosophical foundation for both community psychology and team science, and how this foundation aligns well with contemporary developments in science that emphasize the co-production of knowledge. I conclude with a discussion of how the co-production of knowledge in team science can promote justice.
Collapse
Affiliation(s)
- Jacob Kraemer Tebes
- Division of Prevention and Community Research & The Consultation Center, Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
| |
Collapse
|
40
|
Vidal C, Polo R, Alvarez K, Falgas-Bague I, Wang Y, Lê Cook B, Alegría M. Co-Occurrence of Posttraumatic Stress Disorder and Cardiovascular Disease Among Ethnic/Racial Groups in the United States. Psychosom Med 2018; 80:680-688. [PMID: 29781946 PMCID: PMC6113076 DOI: 10.1097/psy.0000000000000601] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
OBJECTIVE Trauma and/or symptoms of posttraumatic stress disorder (PTSD) have been linked to the onset of cardiovascular disease (CVD), but the exact mechanism has not been determined. We examine whether the risk of CVD is different among those who have a history of trauma without PTSD symptoms, those who have experienced trauma and developed any symptoms of PTSD, and those with a PTSD diagnosis. Furthermore, we examine whether this association varies across ethnic/racial groups. METHODS We used two data sets that form part of the Collaborative Psychiatric Epidemiology Surveys - the National Latino and Asian American Study and the National Comorbidity Survey Replication. RESULTS We found an increased likelihood of cardiovascular events for those with a diagnosis of PTSD (odds ratio [OR] = 2.10, 95% CI = 1.32-3.33) when compared with those who had not experienced trauma. We did not find an increased risk for those who had experienced trauma without symptoms or with subclinical symptoms of PTSD. The higher likelihood of having a cardiovascular event in those with PTSD was significant for non-Latino whites (OR = 1.86, 95% CI = 1.08-3.11), Latinos (OR = 1.94, 95% CI = 1.04-3.62), and non-Latino blacks (OR = 3.73, 95% CI = 1.76-7.91), but not for Asian respondents. CONCLUSIONS The constellation of symptoms defining PTSD diagnosis reflect adverse reactions to traumatic events and indicate that complex responses to traumatic events may be a risk factor for CVD.
Collapse
Affiliation(s)
- Carmen Vidal
- From the Fundación Jiménez Díaz, Avda, Reyes Católicos, Madrid, Spain (Vidal, Polo); Disparities Research Unit, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston (Alvarez, Falgas-Bague, Wang, Alegría); Health Equity Research Lab, Cambridge Health Alliance and Harvard Medical School, Cambridge, Massachusetts (Lê Cook); and Department of Psychiatry, Harvard Medical School (Lê Cook), Departments of Medicine and Psychiatry, Harvard Medical School, Boston, Massachusetts (Alegría)
| | | | | | | | | | | | | |
Collapse
|
41
|
Abstract
The number of children affected by natural disasters each year is alarmingly high and can be expected to rise as climate change continues. The mental consequences have been documented not only in the rates of post-traumatic stress symptoms and post-traumatic stress disorder, but also for depression and other mental health problems. To contribute towards the knowledge in this area, this special issue of the European Journal of Psychotraumatology focuses on how children can be prepared for natural disasters and the mental health aspects of such events. It includes articles on communicating risks to children, involving children in disaster risk reduction, and the mental health consequences for children from an earthquake, a volcanic eruption, a flood and a hurricane. In this special issue specifically focusing on children and natural disasters, we hope to enhance our understanding of some of the complex pathways and pave the way for improving our interventions.
Collapse
Affiliation(s)
- Atle Dyregrov
- Center for Crisis Psychology, Faculty of Psychology, University of Bergen, Bergen, Norway
| | - William Yule
- Institute of Psychiatry, Psychology and Neurosciences, King’s College, London, UK
| | - Miranda Olff
- Department of Psychiatry, Academic Medical Center at the University of Amsterdam, Amsterdam, The Netherlands
- Arq Psychotrauma Expert Group, Diemen, The Netherlands
| |
Collapse
|
42
|
Groh EM, Feingold PL, Hashimoto B, McDuffie LA, Markel TA. Temporal Variations in Pediatric Trauma: Rationale for Altered Resource Utilization. Am Surg 2018. [DOI: 10.1177/000313481808400624] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Trauma is a major cause of morbidity and mortality in the pediatric population. However, temporal variations of trauma have not been well characterized and may have implications for appropriate allocation of hospital resources. Data from patients evaluated at an ACS-verified Level I pediatric trauma center between 2011 and 2015 were retrospectively analyzed. Date and time of injury, type of injury (blunt vs penetrating), and postemergency department disposition were reviewed. To assess temporal trends, heatmaps were constructed and a mixed poisson regression model was used to assess statistical significance. Pediatric trauma from blunt and penetrating injuries occurred at significantly higher rates between the hours of 1800 and 0100, on weekends compared with weekdays, and from May to August compared with November to February. These data provide useful information for hospital resource utilization. The emergency department, operating room, and intensive care unit should be prepared for increased trauma-related volume between May and August, weekends, and evening hours by appropriately increasing staff volume and resource availability.
Collapse
Affiliation(s)
- Eric M. Groh
- Division of Pediatric Surgery, Department of Surgery, Indiana University School of Medicine, Indianapolis, Indiana
- Thoracic and Gastrointestinal Oncology Branch, National Cancer Institute, Bethesda, Maryland
| | - Paul L. Feingold
- Thoracic and Gastrointestinal Oncology Branch, National Cancer Institute, Bethesda, Maryland
| | - Barry Hashimoto
- Department of International Studies, American University of Sharjah, Sharjah, United Arab Emirates
| | - Lucas A. McDuffie
- Division of Pediatric Surgery, Department of Surgery, Indiana University School of Medicine, Indianapolis, Indiana
| | - Troy A. Markel
- Division of Pediatric Surgery, Department of Surgery, Indiana University School of Medicine, Indianapolis, Indiana
| |
Collapse
|
43
|
Public health actions to mitigate long-term consequences of child maltreatment. J Public Health Policy 2018; 39:294-303. [DOI: 10.1057/s41271-018-0129-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
|
44
|
Hoysted C, Babl FE, Kassam-Adams N, Landolt MA, Jobson L, Van Der Westhuizen C, Curtis S, Kharbanda AB, Lyttle MD, Parri N, Stanley R, Alisic E. Knowledge and training in paediatric medical traumatic stress and trauma-informed care among emergency medical professionals in low- and middle-income countries. Eur J Psychotraumatol 2018; 9:1468703. [PMID: 29760867 PMCID: PMC5944367 DOI: 10.1080/20008198.2018.1468703] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/02/2018] [Accepted: 03/26/2018] [Indexed: 11/23/2022] Open
Abstract
Background: Provision of psychosocial care, in particular trauma-informed care, in the immediate aftermath of paediatric injury is a recommended strategy to minimize the risk of paediatric medical traumatic stress. Objective: To examine the knowledge of paediatric medical traumatic stress and perspectives on providing trauma-informed care among emergency staff working in low- and middle-income countries (LMICs). Method: Training status, knowledge of paediatric medical traumatic stress, attitudes towards incorporating psychosocial care and barriers experienced were assessed using an online self-report questionnaire. Respondents included 320 emergency staff from 58 LMICs. Data analyses included descriptive statistics, t-tests and multiple regression. Results: Participating emergency staff working in LMICs had a low level of knowledge of paediatric medical traumatic stress. Ninety-one percent of respondents had not received any training or education in paediatric medical traumatic stress, or trauma-informed care for injured children, while 94% of respondents indicated they wanted training in this area. Conclusions: There appears to be a need for training and education of emergency staff in LMICs regarding paediatric medical traumatic stress and trauma-informed care, in particular among staff working in comparatively lower income countries.
Collapse
Affiliation(s)
- Claire Hoysted
- School of Psychological Sciences and Monash Institute of Cognitive and Clinical Neuroscience, Monash University, Melbourne, Australia
| | - Franz E Babl
- Emergency Department, Royal Children's Hospital, Melbourne, Australia.,Emergency Research, Murdoch Children's Research Institute, Melbourne, Australia.,Department of Paediatrics, University of Melbourne, Melbourne, Australia, on behalf of the Paediatric Research in Emergency Departments International Collaborative (PREDICT) and the Pediatric Emergency Research Networks (PERN)
| | - Nancy Kassam-Adams
- Centre for Injury Research and Prevention, Children's Hospital of Philadelphia, Philadelphia, PA, USA.,Department of Pediatrics, University of Pennsylvania, Philadelphia, PA, USA
| | - Markus A Landolt
- Department of Psychosomatics and Psychiatry, University Children's Hospital Zurich, Zurich, Switzerland.,Division of Child and Adolescent Health Psychology, Department of Psychology, University of Zurich, Zurich, Switzerland
| | - Laura Jobson
- School of Psychological Sciences and Monash Institute of Cognitive and Clinical Neuroscience, Monash University, Melbourne, Australia
| | - Claire Van Der Westhuizen
- Department of Psychiatry and Mental Health University of Cape Town, Alan J. Flisher Centre for Public Mental Health, Cape Town, South Africa
| | - Sarah Curtis
- Departments of Pediatrics & Emergency Medicine & Women and Children's Health Research Institute, University of Alberta, Edmonton, Canada, on behalf of the Pediatric Emergency Research Canada (PERC)
| | - Anupam B Kharbanda
- Department of Pediatric Emergency Medicine, Children's Hospitals and Clinics of Minnesota, Minneapolis, USA, on behalf of the Pediatric Emergency Medicine Collaborative Research Committee of the American Academy of Pediatrics (PEMCRC)
| | - Mark D Lyttle
- Emergency Department, Bristol Royal Hospital for Children, Upper Maudlin Street, Bristol, UK, on behalf of the Paediatric Emergency Research in the UK and Ireland (PERUKI).,Faculty of Health and Applied Sciences, University of the West of England, Bristol, UK
| | - Niccolò Parri
- Department of Emergency Medicine and Trauma Center, Meyer University Children's Hospital, Florence, Italy, on behalf of the Research in European Pediatric Emergency Medicine (REPEM)
| | - Rachel Stanley
- Department of Emergency Medicine, University of Michigan, Ann Arbor, USA, on behalf of the Pediatric Emergency Care Applied Research Network (PECARN)
| | - Eva Alisic
- Emergency Research, Murdoch Children's Research Institute, Melbourne, Australia.,Department of Psychosomatics and Psychiatry, University Children's Hospital Zurich, Zurich, Switzerland.,Monash University Accident Research Centre, Monash University, Melbourne, Australia
| |
Collapse
|
45
|
Schnyder U, Schäfer I, Aakvaag HF, Ajdukovic D, Bakker A, Bisson JI, Brewer D, Cloitre M, Dyb GA, Frewen P, Lanza J, Le Brocque R, Lueger-Schuster B, Mwiti GK, Oe M, Rosner R, Schellong J, Shigemura J, Wu K, Olff M. The global collaboration on traumatic stress. Eur J Psychotraumatol 2017; 8:1403257. [PMID: 29435201 PMCID: PMC5800488 DOI: 10.1080/20008198.2017.1403257] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/20/2017] [Accepted: 11/02/2017] [Indexed: 11/18/2022] Open
Abstract
Trauma is a global issue. The great majority of the global burden of disease arising from mental health conditions occurs in low- and middle-income countries (LMICs), among populations in political, economic, and/or cultural transition and those struck by forced migration. These mental health problems frequently arise as a result of traumatic events that adversely affect adults, children, and families, including war, mass violence, natural disasters, and accidents. In response to this, the International Society for Traumatic Stress Studies (ISTSS) launched the Global Initiative to have a stronger global impact on trauma-related issues. As part of this initiative, the Global Collaboration was established by representatives of eight professional organizations active in the field of traumatic stress. The group decided to focus on childhood abuse and neglect as its first collaboration. They collected guidelines worldwide, providing the basis for a synthesized core guide for prevention and treatment that can be customized for specific cultural contexts. The resulting 'Internet information on Childhood Abuse and Neglect' (iCAN) is a comprehensive guide for adults who have been affected by childhood abuse and neglect, as well as for the survivors' significant others. It is currently provided in eight languages, and is freely available at the homepage of ISTSS and other websites. A second achievement of the Global Collaboration is the validation of the Computerized Childhood Attachment and Relational Trauma Screen (CARTS), a self-report measure designed to measure occurrences of childhood maltreatment, and its translation into multiple languages, including Croatian, Dutch, French, Georgian, German, Italian, Japanese, Norwegian, Russian, and Spanish. A study is currently planned to collect normative responses to the questionnaire, and to conduct cross-cultural comparisons. The Global Collaboration's success may be seen as an encouraging step towards a truly global structure in the field of traumatic stress.
Collapse
Affiliation(s)
- Ulrich Schnyder
- Department of Psychiatry and Psychotherapy, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Ingo Schäfer
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Helene F. Aakvaag
- Norwegian Centre for Violence and Traumatic Stress Studies, Oslo, Norway
| | - Dean Ajdukovic
- Department of Psychology, Faculty of Humanities and Social Sciences, University of Zagreb, Zagreb, Croatia
| | - Anne Bakker
- Department of Psychiatry, Academic Medical Center at the University of Amsterdam, Amsterdam, The Netherlands
| | - Jonathan I. Bisson
- Division of Psychological Medicine and Clinical Neurosciences, Cardiff University School of Medicine, Cardiff, UK
| | - Douglas Brewer
- Ramsay Health Care, The Hollywood Clinic, Perth, Australia
| | - Marylène Cloitre
- National Center for PTSD Dissemination and Training Division, VA Palo Alto Health Care System, Department of Psychiatry and Behavioral Sciences, Stanford University, Menlo Park, CA, USA
| | - Grete A. Dyb
- Norwegian Centre for Violence and Traumatic Stress Studies, Oslo, Norway
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Paul Frewen
- Department of Psychiatry, Western University, London, Canada
| | - Juliana Lanza
- Argentine Society for Psychotrauma, Buenos Aires, Argentina
| | - Robyne Le Brocque
- School of Nursing, Midwifery, and Social Work, University of Queensland, Brisbane, Australia
| | | | - Gladys K. Mwiti
- Oasis Africa Centre for Transformational Psychology & Trauma, Nairobi, Kenya
| | - Misari Oe
- Department of Neuropsychiatry, Kurume University School of Medicine, Kurume, Japan
| | - Rita Rosner
- Department of Psychology, Catholic University Eichstätt-Ingolstadt, Eichstätt, Germany
| | - Julia Schellong
- Department of Psychotherapy and Psychosomatic Medicine, University Hospital Carl Gustav Carus at the Technische Universität Dresden, Dresden, Germany
| | - Jun Shigemura
- Department of Psychiatry, National Defense Medical College, Tokorozawa, Japan
| | - Kitty Wu
- Asian Society for Traumatic Stress Studies, Hong Kong, China
- Clinical Psychological Services, Kwai Chung Hospital, Hospital Authority, Hong Kong, China
| | - Miranda Olff
- Department of Psychiatry, Academic Medical Center at the University of Amsterdam, Amsterdam, The Netherlands
- Arq Psychotrauma Expert Group, Diemen, The Netherlands
| |
Collapse
|
46
|
Schnurr PP, Bryant R, Berliner L, Kilpatrick DG, Rizzo A, Ruzek JI. What I have changed my mind about and why: public health and technology perspectives in the field of trauma studies. Eur J Psychotraumatol 2017; 8:1372007. [PMID: 29075427 PMCID: PMC5632765 DOI: 10.1080/20008198.2017.1372007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2017] [Accepted: 08/16/2017] [Indexed: 12/04/2022] Open
Abstract
Background: This paper is based on a panel discussion at the 32nd annual meeting of the International Society for Traumatic Stress Studies in Dallas, Texas, in November 2016. Objective: Paula Schnurr convened a panel of experts in the fields of public health and technology to address the topic: 'What I have changed my mind about and why.' Method: The panel included Richard Bryant, Lucy Berliner, Dean Kilpatrick, Albert ('Skip') Rizzo, and Josef Ruzek. Results: Panellists discussed innovative strategies for the dissemination of scientific knowledge and evidence-based treatment. Conclusions: Although there are effective treatments, there is a need to enhance the effectiveness of these treatments. There also is a need to develop simpler, low-cost strategies to disseminate effective treatments. However, technology approaches also offer pathways to increased dissemination. Researchers must communicate scientific findings more effectively to impact public opinion and public policy.
Collapse
Affiliation(s)
- Paula P. Schnurr
- National Center for PTSD, White River Junction, VT, USA
- Geisel School of Medicine, Hanover, NH, USA
| | | | - Lucy Berliner
- Harborview Center for Sexual Assault and Traumatic Stress, Seattle, WA, USA
| | | | - Albert Rizzo
- University of Southern California, Los Angeles, CA, USA
| | - Josef I. Ruzek
- National Center for PTSD, White River Junction, VT, USA
- Stanford University School of Medicine, Palo Alto, CA, USA
| |
Collapse
|
47
|
Magruder KM, McLaughlin KA, Elmore Borbon DL. Trauma is a public health issue. Eur J Psychotraumatol 2017; 8:1375338. [PMID: 29435198 PMCID: PMC5800738 DOI: 10.1080/20008198.2017.1375338] [Citation(s) in RCA: 95] [Impact Index Per Article: 13.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2017] [Accepted: 08/30/2017] [Indexed: 01/04/2023] Open
Abstract
Exposure to trauma is pervasive in societies worldwide and is associated with substantial costs to the individual and society, making it a significant global public health concern. We present evidence for trauma as a public health issue by highlighting the role of characteristics operating at multiple levels of influence - individual, relationship, community, and society - as explanatory factors in both the occurrence of trauma and its sequelae. Within the context of this multi-level framework, we highlight targets for prevention of trauma and its downstream consequences and provide examples of where public health approaches to prevention have met with success. Finally, we describe the essential role of public health policies in addressing trauma as a global public health issue, including key challenges for global mental health and next steps for developing and implementing a trauma-informed public health policy agenda. A public health framework is critical for understanding risk and protective factors for trauma and its aftermath operating at multiple levels of influence and generating opportunities for prevention.
Collapse
Affiliation(s)
- Kathryn M. Magruder
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, S.C, U.S.A
| | | | - Diane L. Elmore Borbon
- Department of Psychiatry and Behavioral Sciences, UCLA-Duke University National Center for Child Traumatic Stress, Washington, D.C, U.S.A
| |
Collapse
|
48
|
Alisic E, Tyler MP, Giummarra MJ, Kassam-Adams R, Gouweloos J, Landolt MA, Kassam-Adams N. Trauma-informed care for children in the ambulance: international survey among pre-hospital providers. Eur J Psychotraumatol 2017; 8:1273587. [PMID: 28326162 PMCID: PMC5328382 DOI: 10.1080/20008198.2016.1273587] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2016] [Revised: 12/05/2016] [Accepted: 12/12/2016] [Indexed: 11/20/2022] Open
Abstract
Background: Pre-hospital providers, such as paramedics and emergency medical technicians, are in a position to provide key emotional support to injured children and their families. Objective: Our goal was to examine (a) pre-hospital providers' knowledge of traumatic stress in children, attitudes towards psychosocial aspects of care, and confidence in providing psychosocial care, (b) variations in knowledge, attitudes, and confidence according to demographic and professional characteristics, and (c) training preferences of pre-hospital providers regarding psychosocial care to support paediatric patients and their families. Method: We conducted a cross-sectional, online survey among an international sample of 812 pre-hospital providers from high-income countries. The questionnaire was adapted from a measure for a similar study among Emergency Department staff, and involved 62 items in 7 main categories (e.g. personal and work characteristics, knowledge of paediatric traumatic stress, and confidence regarding 18 elements of psychosocial care). The main analyses comprised descriptive statistics and multiple regression analyses. Results: On average, respondents answered 2.7 (SD = 1.59) out of seven knowledge questions correctly. Respondents with higher knowledge scores were more often female, parent of a child under 17, and reported that at least 10% of their patients were children. A majority of participants (83.5%) saw all 18 aspects of psychosocial care as part of their job. Providers felt moderately confident (M = 3.2, SD = 0.45) regarding their skills in psychosocial care, which was predicted by gender (female), having more experience, having a larger proportion of child patients, and having received training in psychosocial care in the past five years. Most respondents (89.7%) wanted to gain more knowledge and skills regarding psychosocial care for injured children. In terms of training format, they preferred an interactive website or a one-off group training. Conclusions: There appears to be both a need and an opportunity for education initiatives regarding paediatric traumatic stress in the pre-hospital context.
Collapse
Affiliation(s)
- Eva Alisic
- Monash University Accident Research Centre, Monash University, Clayton, Australia; Department of Psychosomatics and Psychiatry, University Children's Hospital Zurich, Zurich, Switzerland
| | - Mark P Tyler
- School of Psychological Science and Monash Institute of Cognitive and Clinical Neurosciences, Monash University, Clayton, Australia; School of Psychology and Public Health, Department of Psychology and Counselling, La Trobe University, Melbourne, Australia
| | - Melita J Giummarra
- Institute of Safety, Compensation & Recovery Research, Melbourne, Australia; Caulfield Pain Management & Research Centre, Caulfield Hospital, Caulfield, Australia; Department of Epidemiology & Preventive Medicine, Monash University, Melbourne, Australia
| | - Rahim Kassam-Adams
- College of Science and Technology, Temple University , Philadelphia , PA , USA
| | - Juul Gouweloos
- Impact, National Knowledge and Advice Centre for Psychosocial Care Concerning Critical Incidents, Partner in Arq Psychotrauma Expert Group, Diemen, The Netherlands; Department of Clinical and Health Psychology, Utrecht University, Utrecht, The Netherlands
| | - Markus A Landolt
- Department of Psychosomatics and Psychiatry, University Children's Hospital Zurich, Zurich, Switzerland; Division of Child and Adolescent Health Psychology, Department of Psychology, University of Zurich, Zurich, Switzerland
| | - Nancy Kassam-Adams
- Center for Injury Research and Prevention, Children's Hospital of Philadelphia, Philadelphia, PA, USA; School of Medicine, University of Pennsylvania Perelman, Philadelphia, PA, USA
| |
Collapse
|
49
|
Azami-Aghdash S, Sadeghi-Bazargani H, Shabaninejad H, Abolghasem Gorji H. Injury epidemiology in Iran: a systematic review. J Inj Violence Res 2017; 9:852. [PMID: 28039683 PMCID: PMC5279990 DOI: 10.5249/jivr.v9i1.852] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2016] [Accepted: 11/16/2016] [Indexed: 12/13/2022] Open
Abstract
Background: Injuries are the second greatest cause of mortality in Iran. Information about the epidemiological pattern of injuries is effective in decision-making. In this regard, the aim of the current study is to elaborate on the epidemiology of injuries in Iran through a systematic review. Methods: Required data were collected searching the following key words and their Persian equivalents; trauma, injury, accident, epidemiology, prevalence, pattern, etiology, risk factors and Iran. The following databases were searched: Google Scholar, PubMed, Scopus, MagIran, Iranian scientific information database (SID) and Iran Medex. Some of the relevant journals and web sites were searched manually. The lists of references from the selected articles were also investigated. We have also searched the gray literature and consulted some experts. Results: Out of 2747 retrieved articles, 25 articles were finally included in the review. A total of 3234481 cases have been investigated. Mean (SD) age among these cases was 30 (17.4) years. The males comprised 75.7% of all the patients. Only 31.1% of patients were transferred to hospital by ambulance. The most common mechanism of injuries was road traffic accidents (50.1%) followed by falls (22.3%). In road traffic accidents, motorcyclists have accounted for the majority of victims (45%). Roads were the most common accident scene for the injuries (57.5%). The most common injuries were to the head and neck. (47.3%). The mean (SD) Injury Severity Score (ISS) was 8.1(8.6%). The overall case-fatality proportion was 3.8% and 75% of all the mortalities related to road traffic accidents. Conclusions: The main priorities in reducing the burden of injuries include: the young, male target group, improving pre-hospital and ambulance services, preventing road traffic accidents, improving road safety and the safety of motorcyclists (compulsory helmet use, safer vehicles, dedicated motorcycle lanes).
Collapse
Affiliation(s)
| | | | | | - Hassan Abolghasem Gorji
- Department of Health Services Management, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran.
| |
Collapse
|
50
|
Frijling JL. Preventing PTSD with oxytocin: effects of oxytocin administration on fear neurocircuitry and PTSD symptom development in recently trauma-exposed individuals. Eur J Psychotraumatol 2017; 8:1302652. [PMID: 28451068 PMCID: PMC5400019 DOI: 10.1080/20008198.2017.1302652] [Citation(s) in RCA: 59] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2017] [Revised: 03/01/2017] [Accepted: 02/15/2017] [Indexed: 12/18/2022] Open
Abstract
Background: Posttraumatic stress disorder (PTSD) is a debilitating psychiatric disorder which develops in approximately 10% of trauma-exposed individuals. Currently, there are few early preventive interventions available for PTSD. Intranasal oxytocin administration early posttrauma may prevent PTSD symptom development, as oxytocin administration was previously found to beneficially impact neurobiological (e.g. amygdala reactivity) and socio-emotional PTSD vulnerability factors. Objective: The overall aim of this dissertation was to investigate the potential of intranasal oxytocin administration as early preventive intervention for PTSD. Methods: We performed a functional magnetic resonance imaging (fMRI) study to assess the acute effects of a single administration of oxytocin on the functional fear neurocircuitry - consisting of the amygdala and (pre)frontal brain regions - in recently trauma-exposed emergency department patients (range n = 37-41). In addition, we performed a multicentre randomized double-blind placebo-controlled clinical trial (RCT) to assess the efficacy of repeated intranasal oxytocin administration early after trauma for preventing PTSD symptom development up to six months posttrauma (n = 107). Results: In our fMRI experiments we observed acutely increased amygdala reactivity to fearful faces and attenuated amygdala-ventromedial and ventrolateral prefrontal cortex functional connectivity after a single oxytocin administration in recently trauma-exposed individuals. However, in our RCT we found that repeated intranasal oxytocin administration early posttrauma reduced subsequent PTSD symptom development in recently trauma-exposed emergency department patients with high acute PTSD symptoms. Conclusions: These findings indicate that repeated intranasal oxytocin is a promising early preventive intervention for PTSD for individuals at increased risk for PTSD due to high acute symptom severity. Administration frequency dependent effects of oxytocin or the effects of oxytocin administration on salience processing may serve as explanatory frameworks for the contrasting oxytocin effects on anxiety-related measures in our clinical and neuroimaging studies.
Collapse
Affiliation(s)
- Jessie L Frijling
- Department of Psychiatry, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands
| |
Collapse
|