1
|
Liddell BJ, Das P, Malhi GS, Jobson L, Lau W, Felmingham KL, Nickerson A, Askovic M, Aroche J, Coello M, Bryant RA. Self-construal modulates default mode network connectivity in refugees with PTSD. J Affect Disord 2024; 361:268-276. [PMID: 38866252 DOI: 10.1016/j.jad.2024.06.009] [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: 02/28/2024] [Revised: 05/28/2024] [Accepted: 06/03/2024] [Indexed: 06/14/2024]
Abstract
BACKGROUND While self-construal and posttraumatic stress disorder (PTSD) are independently associated with altered self-referential processes and underlying default mode network (DMN) functioning, no study has examined how self-construal affects DMN connectivity in PTSD. METHODS A final sample of 93 refugee participants (48 with DSM-5 PTSD or sub-syndromal PTSD and 45 matched trauma-exposed controls) completed a 5-minute resting state fMRI scan to enable the observation of connectivity in the DMN and other core networks. A self-construal index was calculated by substracting scores on the collectivistic and individualistic sub-scales of the Self Construal Scale. RESULTS Independent components analysis identified 9 active networks-of-interest, and functional network connectivity was determined. A significant interaction effect between PTSD and self-construal index was observed in the anterior ventromedial DMN, with spatial maps localizing this to the left ventromedial prefrontal cortex (vmPFC), extending to the ventral anterior cingulate cortex. This effect revealed that connectivity in the vMPFC showed greater reductions in those with PTSD with higher levels of collectivistic self-construal. LIMITATIONS This is an observational study and causality cannot be assumed. The specialized sample of refugees means that the findings may not generalize to other trauma-exposed populations. CONCLUSIONS Such a finding indicates that self-construal may shape the core neural architecture of PTSD, given that functional disruptions to the vmPFC underpin the core mechanisms of extinction learning, emotion dysregulation and self-referential processing in PTSD. Results have important implications for understanding the universality of neural disturbances in PTSD, and suggest that self-construal could be an important consideration in the assessment and treatment of post-traumatic stress reactions.
Collapse
Affiliation(s)
- Belinda J Liddell
- School of Psychological Sciences, University of Newcastle, Australia; School of Psychology, UNSW Sydney, Australia.
| | - Pritha Das
- School of Psychological Sciences, University of Newcastle, Australia; Academic Department of Psychiatry, Northern Sydney Local Health District, CADE Clinic, Royal North Shore Hospital, Northern Sydney Local Health District, St Leonards, NSW 2065, Australia
| | - Gin S Malhi
- Academic Department of Psychiatry, Northern Sydney Local Health District, CADE Clinic, Royal North Shore Hospital, Northern Sydney Local Health District, St Leonards, NSW 2065, Australia; University of Sydney, Faculty of Medicine and Health, Northern Clinical School, Department of Psychiatry, Sydney, New South Wales, Australia.; Department of Psychiatry, University of Oxford, Oxford, UK
| | | | - Winnie Lau
- Phoenix Australia, University of Melbourne, Australia
| | - Kim L Felmingham
- School of Psychological Sciences, University of Melbourne, Australia
| | | | - Mirjana Askovic
- NSW Service for the Treatment and Rehabilitation of Torture and Trauma Survivors (STARTTS), Sydney, Australia
| | - Jorge Aroche
- NSW Service for the Treatment and Rehabilitation of Torture and Trauma Survivors (STARTTS), Sydney, Australia
| | - Mariano Coello
- NSW Service for the Treatment and Rehabilitation of Torture and Trauma Survivors (STARTTS), Sydney, Australia
| | | |
Collapse
|
2
|
Li X. Applicability of the Hebrew Bible to Post-traumatic Stress Disorder and Post-traumatic Growth. JOURNAL OF RELIGION AND HEALTH 2024:10.1007/s10943-023-01987-1. [PMID: 38219271 DOI: 10.1007/s10943-023-01987-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 12/14/2023] [Indexed: 01/16/2024]
Abstract
Since the new millennium, biblical scholars have begun to reread certain writings in the Hebrew Bible through the concepts of post-traumatic stress disorder and post-traumatic growth. Some scholars believe such a reading is legitimate, whereas others think it problematic, and still, others hold a midway perspective. This article argues for the midway, the position that accepts the applicability of the Hebrew Bible to today's psychological concepts but calls for caution. Because ancient Israelites reacted to traumatic events and distinguished the human mind from the body like modern people, it is reasonable to approach their thoughts and emotions in the Hebrew Bible through today's psychological concepts. However, the cultural differences between today's society and ancient Israelites in understanding and reacting to traumatic events should be considered.
Collapse
Affiliation(s)
- Xi Li
- Center for Judaic and Interreligious Studies of Shandong University, Qingjiao Building 4-1-202, Erhuangdong Road, 12550, Shizhong Qu, Jinan, 250002, Shandong, China.
| |
Collapse
|
3
|
Bruce MJ, Handal P. Revisiting the Factor Structure of the Centrality of Event Scale. OMEGA-JOURNAL OF DEATH AND DYING 2023:302228231162211. [PMID: 36880709 DOI: 10.1177/00302228231162211] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/08/2023]
Abstract
Traumatic experiences that become self-defining impact posttraumatic outcomes, yet exact mechanisms are currently being studied. Recent research has used the Centrality of Event Scale (CES). However, the factor structure of the CES has been in question. We analyzed archival data (N = 318) split into homogenous groups of participants to examine whether the factor structure of the CES differed based on event type (bereavement vs. sexual assault) or by levels of PTSD (meeting clinical cut off score vs. group of lowest scorers). Exploratory factor analyses with subsequent confirmatory analyses revealed a single factor model in the bereavement group, sexual assault group, and the low PTSD group. A three-factor model emerged in the high PTSD group, with the factors' themes matching previous findings. Event centrality appears to be a universal theme when people endure and process a diversity of adverse events. These distinct factors may illuminate pathways in the clinical syndrome.
Collapse
Affiliation(s)
- Madeline J Bruce
- Department of Psychology, Saint Louis University, Saint Louis, MO, USA
| | - Paul Handal
- Department of Psychology, Saint Louis University, Saint Louis, MO, USA
| |
Collapse
|
4
|
Singleton SP, Wang JB, Mithoefer M, Hanlon C, George MS, Mithoefer A, Mithoefer O, Coker AR, Yazar-Klosinski B, Emerson A, Doblin R, Kuceyeski A. Altered brain activity and functional connectivity after MDMA-assisted therapy for post-traumatic stress disorder. Front Psychiatry 2023; 13:947622. [PMID: 36713926 PMCID: PMC9879604 DOI: 10.3389/fpsyt.2022.947622] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Accepted: 12/19/2022] [Indexed: 01/15/2023] Open
Abstract
Introduction 3,4-methylenedioxymethamphetamine-assisted therapy (MDMA-AT) for post-traumatic stress disorder (PTSD) has demonstrated promise in multiple clinical trials. MDMA is hypothesized to facilitate the therapeutic process, in part, by decreasing fear response during fear memory processing while increasing extinction learning. The acute administration of MDMA in healthy controls modifies recruitment of brain regions involved in the hyperactive fear response in PTSD such as the amygdala, hippocampus, and insula. However, to date there have been no neuroimaging studies aimed at directly elucidating the neural impact of MDMA-AT in PTSD patients. Methods We analyzed brain activity and connectivity via functional MRI during both rest and autobiographical memory (trauma and neutral) response before and two-months after MDMA-AT in nine veterans and first-responders with chronic PTSD of 6 months or more. Results We hypothesized that MDMA-AT would increase amygdala-hippocampus resting-state functional connectivity, however we only found evidence of a trend in the left amygdala-left hippocampus (t = -2.91, uncorrected p = 0.0225, corrected p = 0.0901). We also found reduced activation contrast (trauma > neutral) after MDMA-AT in the cuneus. Finally, the amount of recovery from PTSD after MDMA-AT correlated with changes in four functional connections during autobiographical memory recall: the left amygdala-left posterior cingulate cortex (PCC), left amygdala-right PCC, left amygdala-left insula, and left isthmus cingulate-left posterior hippocampus. Discussion Amygdala-insular functional connectivity is reliably implicated in PTSD and anxiety, and both regions are impacted by MDMA administration. These findings compliment previous research indicating that amygdala, hippocampus, and insula functional connectivity is a potential target of MDMA-AT, and highlights other regions of interest related to memory processes. More research is necessary to determine if these findings are specific to MDMA-AT compared to other types of treatment for PTSD. Clinical trial registration https://clinicaltrials.gov/ct2/show/NCT02102802, identifier NCT02102802.
Collapse
Affiliation(s)
- S. Parker Singleton
- Department of Computational Biology, Cornell University, Ithaca, NY, United States
| | - Julie B. Wang
- MAPS Public Benefit Corporation, San Jose, CA, United States
| | - Michael Mithoefer
- MAPS Public Benefit Corporation, San Jose, CA, United States
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, United States
| | - Colleen Hanlon
- Wake Forest School of Medicine, Winston-Salem, NC, United States
| | - Mark S. George
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, United States
- Ralph H. Johnson VA Medical Center, Charleston, SC, United States
| | - Annie Mithoefer
- MAPS Public Benefit Corporation, San Jose, CA, United States
| | - Oliver Mithoefer
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, United States
| | - Allison R. Coker
- MAPS Public Benefit Corporation, San Jose, CA, United States
- Department of Neurology, University of California, San Francisco, San Francisco, CA, United States
| | | | - Amy Emerson
- MAPS Public Benefit Corporation, San Jose, CA, United States
| | - Rick Doblin
- Multidisciplinary Association for Psychedelic Studies, San Jose, CA, United States
| | - Amy Kuceyeski
- Department of Computational Biology, Cornell University, Ithaca, NY, United States
- Department of Radiology, Weill Cornell Medicine, New York, NY, United States
| |
Collapse
|
5
|
Scharpf F, Saupe L, Crombach A, Haer R, Ibrahim H, Neuner F, Peltonen K, Qouta S, Saile R, Hecker T. The network structure of posttraumatic stress symptoms in war‐affected children and adolescents. JCPP ADVANCES 2022. [DOI: 10.1002/jcv2.12124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Affiliation(s)
- Florian Scharpf
- Department of Psychology Bielefeld University Bielefeld Germany
- Institute for Interdisciplinary Research on Conflict and Violence Bielefeld University Bielefeld Germany
| | - Laura Saupe
- Department of Psychology University Eichstätt‐Ingolstadt Eichstätt Germany
| | - Anselm Crombach
- Department of Psychology Konstanz University Konstanz Germany
- Department of Psychology Saarland University Saarbrücken Germany
| | - Roos Haer
- Institute of Political Science Leiden University Leiden Netherlands
| | - Hawkar Ibrahim
- Department of Psychology Bielefeld University Bielefeld Germany
| | - Frank Neuner
- Department of Psychology Bielefeld University Bielefeld Germany
| | - Kirsi Peltonen
- Research Center for Child Psychiatry University of Turku Turku Finland
| | - Samir Qouta
- School of Social Sciences and Humanities Doha Instiute for Graduate Studies Al Daayen Qatar
| | - Regina Saile
- Treatment Center for Victims of Torture Ulm Germany
| | - Tobias Hecker
- Department of Psychology Bielefeld University Bielefeld Germany
- Institute for Interdisciplinary Research on Conflict and Violence Bielefeld University Bielefeld Germany
| |
Collapse
|
6
|
Jobson L, Haque S, Abdullah SZ, Lee B, Li H, Reyneke T, Tan BKW, Lau W, Liddell B. Examining Cultural Differences in the Associations between Appraisals and Emotion Regulation and PostTraumatic Stress Disorder in Malaysian and Australian Trauma Survivors. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19031163. [PMID: 35162187 PMCID: PMC8834521 DOI: 10.3390/ijerph19031163] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Revised: 01/10/2022] [Accepted: 01/17/2022] [Indexed: 12/04/2022]
Abstract
Appraisals and emotional regulation play a central role in posttraumatic stress disorder (PTSD). Despite research demonstrating cultural differences in everyday appraisals and emotion regulation, little research has investigated the influence of culture on these processes in PTSD. This study examined cultural differences in the associations between appraisals, emotion regulation and PTSD symptoms using trauma survivors from an individualistic Western culture (Australia) and a collectivistic Asian culture (Malaysia). Trauma survivors (N = 228; 107 Australian with European cultural heritage, 121 Malaysian with Malay, Indian or Chinese cultural heritage) completed an on-line survey assessing PTSD (PTSD Checklist for the DSM-5 with Life Events Checklist), appraisals (trauma-related, fatalism, cultural beliefs about adversity) and emotion regulation (suppression, reappraisal, interpersonal). The Malaysian group reported significantly greater fatalism, cultural beliefs about adversity, suppression and interpersonal emotion regulation than the Australian group. Greater trauma-specific appraisals, greater suppression, fewer cultural beliefs about adversity, and less use of social skills to enhance positivity were generally associated with greater PTSD symptom severity, with little evidence of cultural group moderating these associations. Interdependent self-construal mediated the relationships between cultural adversity beliefs, enhanced positivity, reappraisal, perspective taking and PTSD symptoms. Independent self-construal mediated the relationships between fatalism and perspective taking and PTSD symptoms. Cultural group did not moderate these indirect effects. Interdependent self-construal mediated the associations between interpersonal regulation strategies of soothing and social modelling with PTSD symptoms for the Malaysian but not the Australian group. These findings demonstrate the importance of considering self-construal and culture in understanding factors associated with PTSD.
Collapse
Affiliation(s)
- Laura Jobson
- Turner Institute for Brain and Mental Health and School of Psychological Sciences, Monash University, Clayton, VIC 3800, Australia; (B.L.); (H.L.); (T.R.)
- Correspondence: ; Tel.: +61-399-053-945
| | - Shamsul Haque
- Department of Psychology, Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Subang Jaya 47500, Malaysia; (S.H.); (S.Z.A.); (B.K.W.T.)
| | - Siti Zainab Abdullah
- Department of Psychology, Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Subang Jaya 47500, Malaysia; (S.H.); (S.Z.A.); (B.K.W.T.)
| | - Bryan Lee
- Turner Institute for Brain and Mental Health and School of Psychological Sciences, Monash University, Clayton, VIC 3800, Australia; (B.L.); (H.L.); (T.R.)
| | - Haoxiang Li
- Turner Institute for Brain and Mental Health and School of Psychological Sciences, Monash University, Clayton, VIC 3800, Australia; (B.L.); (H.L.); (T.R.)
| | - Tamsyn Reyneke
- Turner Institute for Brain and Mental Health and School of Psychological Sciences, Monash University, Clayton, VIC 3800, Australia; (B.L.); (H.L.); (T.R.)
| | - Britney Kerr Wen Tan
- Department of Psychology, Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Subang Jaya 47500, Malaysia; (S.H.); (S.Z.A.); (B.K.W.T.)
| | - Winnie Lau
- Phoenix Australia-Centre for Posttraumatic Mental Health, Department of Psychiatry, University of Melbourne, Carlton, VIC 3053, Australia;
| | - Belinda Liddell
- School of Psychology, University of New South Wales, Sydney, NSW 2052, Australia;
| |
Collapse
|
7
|
Eder-Moreau E, Zhu X, Fisch CT, Bergman M, Neria Y, Helpman L. Neurobiological Alterations in Females With PTSD: A Systematic Review. Front Psychiatry 2022; 13:862476. [PMID: 35770056 PMCID: PMC9234306 DOI: 10.3389/fpsyt.2022.862476] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Accepted: 04/20/2022] [Indexed: 11/13/2022] Open
Abstract
Most females experience at least one traumatic event in their lives, but not all develop PTSD. Despite considerable research, our understanding of the key factors that constitute risk for PTSD among females is limited. Previous research has largely focused on sex differences, neglecting within group comparisons, thereby obviating differences between females who do and do not develop PTSD following exposure to trauma. In this systematic review, we conducted a search for the extent of existing research utilizing magnetic resonance imaging (MRI) to examine neurobiological differences among females of all ages, with and without PTSD. Only studies of females who met full diagnostic criteria for PTSD were included. Fifty-six studies were selected and reviewed. We synthesized here findings from structural MRI (sMRI), functional MRI (fMRI), diffusion tensor imaging (DTI), and resting state functional connectivity (rs-FC MRI) studies, comparing females with and without PTSD. A range of biopsychosocial constructs that may leave females vulnerable to PTSD were discussed. First, the ways timing and type of exposure to trauma may impact PTSD risk were discussed. Second, the key role that cognitive and behavioral mechanisms may play in PTSD was described, including rumination, and deficient fear extinction. Third, the role of specific symptom patterns and common comorbidities in female-specific PTSD was described, as well as sex-specific implications on treatment and parenting outcomes. We concluded by identifying areas for future research, to address the need to better understand developmental aspects of brain alterations, the differential impact of trauma types and timing, the putative role of neuroendocrine system in neurobiology of PTSD among females, and the impact of social and cultural factors on neurobiology in females with PTSD.
Collapse
Affiliation(s)
- Elizabeth Eder-Moreau
- New York State Psychiatric Institute, Columbia University Irving Medical Center, New York, NY, United States
| | - Xi Zhu
- New York State Psychiatric Institute, Columbia University Irving Medical Center, New York, NY, United States.,Department of Psychiatry, Columbia University Irving Medical Center, New York, NY, United States
| | - Chana T Fisch
- New York State Psychiatric Institute, Columbia University Irving Medical Center, New York, NY, United States
| | - Maja Bergman
- New York State Psychiatric Institute, Columbia University Irving Medical Center, New York, NY, United States
| | - Yuval Neria
- New York State Psychiatric Institute, Columbia University Irving Medical Center, New York, NY, United States.,Department of Psychiatry, Columbia University Irving Medical Center, New York, NY, United States
| | - Liat Helpman
- Department of Counseling and Human Development, Faculty of Education, University of Haifa, Haifa, Israel.,Psychiatric Research Unit, Tel Aviv Medical Center, Tel Aviv, Israel
| |
Collapse
|
8
|
Liddell BJ, Byrow Y, O'Donnell M, Mau V, Batch N, McMahon T, Bryant R, Nickerson A. Mechanisms underlying the mental health impact of family separation on resettled refugees. Aust N Z J Psychiatry 2021; 55:699-710. [PMID: 33111540 DOI: 10.1177/0004867420967427] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE Many refugees experience prolonged separation from family members, which research suggests has adverse effects on mental health and post-displacement outcomes in refugee populations. We examine mental health differences in refugees separated and not separated from their families, and key post-migration factors and cultural mechanisms that may underlie this impact. METHODS A sample of 1085 refugees resettled in Australia, of which 23.3% were separated from all of their immediate family, took part in an online battery of survey measures indexing pre- and post-migration refugee experiences, mental health symptoms, disability and individualistic/collectivistic self-identity. Family separation was used as a predictor of mental health outcomes in a series of linear regressions, and the separated and non-separated groups were compared in multigroup path analysis models to examine group-specific indirect effects. RESULTS The separated group reported greater exposure to pre-migration potentially traumatic events and higher levels of post-migration living difficulties compared to the non-separated group. Family separation predicted higher post-traumatic stress and depression symptoms, but not disability, after controlling for potentially traumatic event exposure, age and sex. Path analyses revealed distinct indirect effects for separated and non-separated groups. Principally, higher collectivistic self-identity was associated with elevated post-traumatic stress, depression and disability symptoms via social-related post-migration living difficulties such as isolation and loneliness in the separated group; whereas collectivism was linked with increased depression symptoms via economic-related post-migration living difficulties in the non-separated group. CONCLUSION These findings indicate that family separation powerfully influences mental health outcomes, but that its effect may be mediated by the type of post-migration stress experienced in the settlement environment and culturally bound differences in how the sense of self is interconnected with family.
Collapse
Affiliation(s)
| | - Yulisha Byrow
- School of Psychology, UNSW Sydney, Sydney, NSW, Australia
| | | | - Vicki Mau
- Australian Red Cross, North Melbourne, VIC, Australia
| | - Nicole Batch
- Australian Red Cross, North Melbourne, VIC, Australia
| | - Tadgh McMahon
- Settlement Services International, Ashfield, NSW, Australia
| | - Richard Bryant
- School of Psychology, UNSW Sydney, Sydney, NSW, Australia
| | | |
Collapse
|
9
|
Stupar D, Stevanovic D, Vostanis P, Atilola O, Moreira P, Dodig-Curkovic K, Franic T, Doric A, Davidovic N, Avicenna M, Multazam IN, Nussbaum L, Thabet AA, Ubalde D, Petrov P, Deljkovic A, Monteiro AL, Ribas A, Jovanovic M, Joana O, Knez R. Posttraumatic stress disorder symptoms among trauma-exposed adolescents from low- and middle-income countries. Child Adolesc Psychiatry Ment Health 2021; 15:26. [PMID: 34090487 PMCID: PMC8180049 DOI: 10.1186/s13034-021-00378-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2019] [Accepted: 05/27/2021] [Indexed: 01/24/2023] Open
Abstract
BACKGROUND Exposure to traumatic events in childhood is associated with the development and maintenance of various psychiatric disorders, but most frequently with posttraumatic stress disorder (PTSD). The aim of this study was to evaluate the types of traumatic events experienced and the presence and predictors of PTSD symptoms among adolescents from the general population from ten low- and middle-income countries (LMICs). METHODS Data were simultaneously collected from 3370 trauma-exposed adolescents (mean age = 15.41 [SD = 1.65] years, range 12-18; 1465 (43.5%) males and 1905 (56.5%) females) in Brazil, Bulgaria, Croatia, Indonesia, Montenegro, Nigeria, the Palestinian Territories, the Philippines, Romania, and Serbia, with Portugal, a high-income country, as a reference point. The UCLA PTSD Reaction Index for the DSM-5 (PTSD-RI-5) was used for the assessment of traumatic events and PTSD symptoms. RESULTS The most frequently reported traumatic events were death of a close person (69.7%), witnessing violence other than domestic (40.5%), being in a natural disaster (34.4%) and witnessing violent death or serious injury of a close person (33.9%). In total, 28.5% adolescents endorsed two to three DSM-5 PTSD criteria symptoms. The rates of adolescents with symptoms from all four DSM-5 criteria for PTSD were 6.2-8.1% in Indonesia, Serbia, Bulgaria, and Montenegro, and 9.2-10.5% in Philippines, Croatia and Brazil. From Portugal, 10.7% adolescents fall into this category, while 13.2% and 15.3% for the Palestinian Territories and Nigeria, respectively. A logistic regression model showed that younger age, experiencing war, being forced to have sex, and greater severity of symptoms (persistent avoidance, negative alterations in cognitions and mood, and alterations in arousal and reactivity) were significant predictors of fulfilling full PTSD criteria. CONCLUSIONS Nearly every third adolescent living in LMICs might have some PTSD symptoms after experiencing a traumatic event, while nearly one in ten might have sufficient symptoms for full DSM-5 PTSD diagnosis. The findings can inform the generation of PTSD burden estimates, allocation of health resources, and designing and implementing psychosocial interventions for PTSD in LMICs.
Collapse
Affiliation(s)
- Dusko Stupar
- Clinic for Neurology and Psychiatry for Children and Youth, Belgrade, Serbia
| | - Dejan Stevanovic
- Clinic for Neurology and Psychiatry for Children and Youth, Belgrade, Serbia
| | - Panos Vostanis
- School of Psychology, Leicester University, Leicester, UK
| | - Olayinka Atilola
- Department of Behavioural Medicine, Lagos State University College of Medicine Ikeja, Lagos, Nigeria
| | - Paulo Moreira
- Lusíada University, Porto, Portugal
- CIPD, Porto, Portugal
| | | | - Tomislav Franic
- Child and Adolescent Psychiatry, School of Medicine, University of Split, Split, Croatia
| | - Ana Doric
- Department of Psychology, Faculty of Humanities and Social Sciences, Rijeka, Croatia
| | - Nikolina Davidovic
- Child and Adolescent Psychiatry, School of Medicine, University of Split, Split, Croatia
| | - Mohamad Avicenna
- Faculty of Psychology, State Islamic University Syarif Hidayatullah, Jakarta, Indonesia
| | | | - Laura Nussbaum
- Department of Child and Adolescent Psychiatry, University of Medicine and Pharmacy "Victor Babes", Timisoara, Romania
| | - Abdul Aziz Thabet
- School of Public Health, Gaza Branch, Al Quds University, Jerusalem, Palestinian Territories, Israel
| | - Dino Ubalde
- Department of Psychology, St. Dominic College of Asia, City of Bacoor, Bacoor, Philippines
| | - Petar Petrov
- Department of Child and Adolescent Psychiatry, University Hospital St. Marina, Varna, Bulgaria
| | | | | | - Adriana Ribas
- Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | | | | | - Rajna Knez
- Department of Pediatrics, Skaraborgs Hospital Skövde, Skövde, Sweden.
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
| |
Collapse
|
10
|
Bernardi J, Engelbrecht A, Jobson L. The impact of culture on cognitive appraisals: Implications for the development, maintenance, and treatment of posttraumatic stress disorder. CLIN PSYCHOL-UK 2020. [DOI: 10.1111/cp.12161] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Jessica Bernardi
- Monash Institute of Cognitive and Clinical Neuroscience, School of Psychological Sciences, Monash University, Clayton, Victoria, Australia,
| | - Alberta Engelbrecht
- Monash Institute of Cognitive and Clinical Neuroscience, School of Psychological Sciences, Monash University, Clayton, Victoria, Australia,
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK,
| | - Laura Jobson
- Monash Institute of Cognitive and Clinical Neuroscience, School of Psychological Sciences, Monash University, Clayton, Victoria, Australia,
| |
Collapse
|
11
|
Sakuma A, Ueda I, Shoji W, Tomita H, Matsuoka H, Matsumoto K. Trajectories for Post-traumatic Stress Disorder Symptoms Among Local Disaster Recovery Workers Following the Great East Japan Earthquake: Group-based Trajectory Modeling. J Affect Disord 2020; 274:742-751. [PMID: 32664010 PMCID: PMC7261355 DOI: 10.1016/j.jad.2020.05.152] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2019] [Revised: 05/18/2020] [Accepted: 05/22/2020] [Indexed: 12/31/2022]
Abstract
BACKGROUND As many local municipality and medical workers were involved in disaster recovery duties following the Great East Japan Earthquake (GEJE) on March 11, 2011, the aim of this work was to elucidate the distinct trajectories for post-traumatic stress disorder (PTSD) symptoms and associated factors among these personnel. They confronted a diverse range of stressors both as survivors and as relief workers; however, little is known about their longitudinal PTSD symptoms. METHODS The participants were 745 local municipality and hospital medical workers [average age: 43.6 ± 9.5 years, range: 20 - 66 years; 306 (59%) women] involved in disaster recovery duties following the GEJE. PTSD symptoms were measured using the Japanese version of the PTSD Checklist Specific Version (PCL-S) at four time points: 14, 30, 43, and 54 months after the GEJE. Using group-based trajectory modeling, distinct trajectories were elucidated. RESULTS We identified five distinct PTSD symptoms profiles: resistance (n = 467, 62.7%), subsyndromal (n = 181, 24.3%), recovery (n = 47, 6.3%), fluctuating (n = 26, 3.5%), and chronic (n = 24, 3.2%). The trajectories differed according to the post-disaster working conditions and personal disaster experiences. LIMITATIONS Potential selection bias resulting from the limited number of participants who completed all waves. The survey was conducted in one region of the disaster area. CONCLUSIONS The majority of participants remained stable, with a relatively small group classified as chronic and fluctuating. Our results highlight the importance of improved working conditions and sustained monitoring of workers responding to natural disasters.
Collapse
Affiliation(s)
- Atsushi Sakuma
- Department of Psychiatry, Tohoku University Hospital; Miyagi Disaster Mental Health Care Center.
| | - Ikki Ueda
- Department of Psychiatry, Tohoku University Hospital,Miyagi Disaster Mental Health Care Center
| | - Wataru Shoji
- Department of Human Science, Faculty of Liberal Arts, Tohoku Gakuin University,Department of Preventive Psychiatry, Tohoku University Graduate School of Medicine
| | - Hiroaki Tomita
- Miyagi Disaster Mental Health Care Center,Department of Preventive Psychiatry, Tohoku University Graduate School of Medicine,Department of Psychiatry, Tohoku University Graduate School of Medicine
| | - Hiroo Matsuoka
- Department of Preventive Psychiatry, Tohoku University Graduate School of Medicine
| | - Kazunori Matsumoto
- Miyagi Disaster Mental Health Care Center,Department of Preventive Psychiatry, Tohoku University Graduate School of Medicine,Department of Psychiatry, Tohoku University Graduate School of Medicine
| |
Collapse
|
12
|
Arias JA, Williams C, Raghvani R, Aghajani M, Baez S, Belzung C, Booij L, Busatto G, Chiarella J, Fu CH, Ibanez A, Liddell BJ, Lowe L, Penninx BWJH, Rosa P, Kemp AH. The neuroscience of sadness: A multidisciplinary synthesis and collaborative review. Neurosci Biobehav Rev 2020; 111:199-228. [PMID: 32001274 DOI: 10.1016/j.neubiorev.2020.01.006] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2018] [Revised: 12/17/2019] [Accepted: 01/05/2020] [Indexed: 02/06/2023]
Abstract
Sadness is typically characterized by raised inner eyebrows, lowered corners of the mouth, reduced walking speed, and slumped posture. Ancient subcortical circuitry provides a neuroanatomical foundation, extending from dorsal periaqueductal grey to subgenual anterior cingulate, the latter of which is now a treatment target in disorders of sadness. Electrophysiological studies further emphasize a role for reduced left relative to right frontal asymmetry in sadness, underpinning interest in the transcranial stimulation of left dorsolateral prefrontal cortex as an antidepressant target. Neuroimaging studies - including meta-analyses - indicate that sadness is associated with reduced cortical activation, which may contribute to reduced parasympathetic inhibitory control over medullary cardioacceleratory circuits. Reduced cardiac control may - in part - contribute to epidemiological reports of reduced life expectancy in affective disorders, effects equivalent to heavy smoking. We suggest that the field may be moving toward a theoretical consensus, in which different models relating to basic emotion theory and psychological constructionism may be considered as complementary, working at different levels of the phylogenetic hierarchy.
Collapse
Affiliation(s)
- Juan A Arias
- Department of Psychology, Swansea University, United Kingdom; Department of Statistics, Mathematical Analysis, and Operational Research, Universidade de Santiago de Compostela, Spain
| | - Claire Williams
- Department of Psychology, Swansea University, United Kingdom
| | - Rashmi Raghvani
- Department of Psychology, Swansea University, United Kingdom
| | - Moji Aghajani
- Department of Psychiatry, Amsterdam UMC, Location VUMC, GGZ InGeest Research & Innovation, Amsterdam Neuroscience, the Netherlands
| | | | | | - Linda Booij
- Department of Psychology, Concordia University Montreal, Canada; CHU Sainte-Justine, University of Montreal, Montreal, Canada
| | | | - Julian Chiarella
- Department of Psychology, Concordia University Montreal, Canada; CHU Sainte-Justine, University of Montreal, Montreal, Canada
| | - Cynthia Hy Fu
- School of Psychology, University of East London, United Kingdom; Centre for Affective Disorders, Institute of Psychiatry, Psychology and Neuroscience, King's College London, United Kingdom
| | - Agustin Ibanez
- Institute of Cognitive and Translational Neuroscience (INCYT), INECO Foundation, Favaloro University, Buenos Aires, Argentina; National Scientific and Technical Research Council (CONICET), Buenos Aires, Argentina; Center for Social and Cognitive Neuroscience (CSCN), School of Psychology, Universidad Adolfo Ibáñez, Santiago, Chile; Universidad Autonoma del Caribe, Barranquilla, Colombia; Centre of Excellence in Cognition and its Disorders, Australian Research Council (ARC), New South Wales, Australia
| | | | - Leroy Lowe
- Neuroqualia (NGO), Turo, Nova Scotia, Canada
| | - Brenda W J H Penninx
- Department of Psychiatry, Amsterdam UMC, Location VUMC, GGZ InGeest Research & Innovation, Amsterdam Neuroscience, the Netherlands
| | - Pedro Rosa
- Department of Psychiatry, University of Sao Paulo, Brazil
| | - Andrew H Kemp
- Department of Psychology, Swansea University, United Kingdom; Department of Psychiatry, University of Sao Paulo, Brazil; Discipline of Psychiatry, and School of Psychology, University of Sydney, Sydney, Australia.
| |
Collapse
|
13
|
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
|
14
|
Bistricky SL, Harper KL, Balderas JC, Cook DM, Rios D, Short MB. Attentional Avoidance of Historically Relevant, Task-Irrelevant Facial Affect: Past Depression, Interpersonal Characteristics, and Ethnicity. Psychol Rep 2019; 123:2263-2281. [PMID: 31422739 DOI: 10.1177/0033294119869825] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Experiential background can influence how individuals respond to affective interpersonal information. For formerly depressed individuals, sad facial expressions are presumably salient. If so, when performing affectively neutral daily tasks, these individuals would find peripheral sad faces particularly distracting, and thus, they might shift their attention from them. The present study examined this hypothesis by comparing how euthymic formerly depressed and never depressed adults attended to sad and happy task-irrelevant emotional facial expression stimuli. The study also measured constructs linked to interpersonal functioning and depression and conducted exploratory analyses to examine whether Hispanic ethnicity status would moderate effects of study outcomes. Results of analyses indicated that formerly depressed individuals directed more attention away from sad faces than never depressed individuals. There were no significant between-group effects for happy faces and no moderation by ethnicity on attention to affective faces. However, irrespective of depression history, Hispanic individuals reported lower fear of negative evaluation compared to non-Hispanic Caucasian individuals. Findings are in line with hypothesized attentional avoidance among formerly depressed individuals and consistent with prior research suggesting that some Hispanic individuals experience protective mental health benefits through engagement with aspects of their culture. Directions for future research are discussed.
Collapse
Affiliation(s)
| | | | | | - Diana M Cook
- University of Houston-Clear Lake, Houston, TX, USA
| | | | - Mary B Short
- University of Houston-Clear Lake, Houston, TX, USA
| |
Collapse
|
15
|
Taku K, Oshio A, Dominick W. Perceived Responsibility and Stressfulness Among College Students in the United States and Japan. JOURNAL OF LOSS & TRAUMA 2019. [DOI: 10.1080/15379418.2018.1549206] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- Kanako Taku
- Department of Psychology, Oakland University, Rochester, Michigan, USA
| | - Atsushi Oshio
- Faculty of Letters, Arts, and Sciences, Waseda University, Tokyo, Japan
| | - Whitney Dominick
- Department of Psychology, Oakland University, Rochester, Michigan, USA
| |
Collapse
|
16
|
Greshake Tzovaras B, Tzovara A. The Personal Data Is Political. PHILOSOPHICAL STUDIES SERIES 2019. [DOI: 10.1007/978-3-030-04363-6_8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
|
17
|
Liddell BJ, Nickerson A, Bryant RA. Clinical science and torture survivors' rights to rehabilitation. Lancet Psychiatry 2018; 5:101-103. [PMID: 29102313 DOI: 10.1016/s2215-0366(17)30332-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2017] [Revised: 07/14/2017] [Accepted: 07/17/2017] [Indexed: 10/18/2022]
|
18
|
Womersley G, Kloetzer L. Being Through Doing: The Self-Immolation of an Asylum Seeker in Switzerland. Front Psychiatry 2018; 9:110. [PMID: 29686628 PMCID: PMC5900890 DOI: 10.3389/fpsyt.2018.00110] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2018] [Accepted: 03/19/2018] [Indexed: 11/13/2022] Open
Abstract
In April 2016, Armin, an asylum seeker in a village of Switzerland, set himself alight in the public square of the town, one of a few cases reported across Europe. He performed the act following a denied request for asylum and was saved by bystanders. We present the results of two qualitative interviews conducted with Armin, his translator and his roommate following the incident. The act is theorized through the lens of a dialogical analysis focusing on the concept of social recognition. The notion of trauma is considered as a key mediating mechanism, theorized as creating ruptures in time, memory, language, and social connections to an Other. We conclude this communicative act to represent both "being-toward-death" and a relational striving toward life; a "destruction as the cause of coming into being."
Collapse
|
19
|
Affiliation(s)
- Ruth Lanius
- Posttraumatic Stress Disorder (PTSD) Research Unit, University of Western Ontario, London, ONN6A 3K7, Canada
| | - Miranda Olff
- Department of Psychiatry, Academic Medical Center, University of Amsterdam & Arq Psychotrauma Expert Group, Diemen, The Netherlands
| |
Collapse
|
20
|
Schnyder U, Bryant RA, Ehlers A, Foa EB, Hasan A, Mwiti G, Kristensen CH, Neuner F, Oe M, Yule W. Culture-sensitive psychotraumatology. Eur J Psychotraumatol 2016; 7:31179. [PMID: 27473520 PMCID: PMC5055610 DOI: 10.3402/ejpt.v7.31179] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2016] [Revised: 06/13/2016] [Accepted: 06/27/2016] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Although there is some evidence of the posttraumatic stress disorder (PTSD) construct's cross cultural validity, trauma-related disorders may vary across cultures, and the same may be true for treatments that address such conditions. Experienced therapists tailor psychotherapy to each patient's particular situation, to the nature of the patient's psychopathology, to the stage of therapy, and so on. In addition, culture-sensitive psychotherapists try to understand how culture enhances the meaning of their patient's life history, the cultural components of their illness and help-seeking behaviors, as well as their expectations with regard to treatment. We cannot take for granted that all treatment-seeking trauma survivors speak our language or share our cultural values. Therefore, we need to increase our cultural competencies. METHODS The authors of this article are clinicians and/or researchers from across the globe, working with trauma survivors in various settings. Each author focused on one or more specific cultural aspects of working with trauma survivors and highlighted the following aspects. RESULTS As a result of culture-specific individual and collective meanings linked to trauma and trauma-related disorders survivors may be exposed to (self-)stigma in the aftermath of trauma. Patients who are reluctant to talk about their traumatic experiences may instead be willing to write or use other ways of accessing the painful memories such as drawing. In other cultures, community and family cohesion are crucial elements of recovery. While awareness of culture-specific aspects is important, we also need to beware of premature cultural stereotyping. When disseminating empirically supported psychotherapies for PTSD across cultures, a number of additional challenges need to be taken into account: many low and middle income countries have very limited resources available and suffer from a poor health infrastructure. CONCLUSIONS In summary, culture-sensitive psychotraumatology means assuming an empathic and non-judgmental attitude, trying to understand each individual's cultural background.
Collapse
Affiliation(s)
- Ulrich Schnyder
- Department of Psychiatry and Psychotherapy, University Hospital, University of Zurich, Zurich, Switzerland;
| | - Richard A Bryant
- School of Psychology, University of New South Wales, Sydney, NSW, Australia
| | - Anke Ehlers
- Department of Experimental Psychology and Oxford Cognitive health NIHR Clinical Research Facility, University of Oxford, Oxford, UK
| | - Edna B Foa
- Department of Psychiatry, Center for the Treatment and Study of Anxiety, University of Pennsylvania, Philadelphia, PA, USA
| | | | - Gladys Mwiti
- Oasis Africa Center for Transformational Psychology & Trauma, Nairobi, Kenya
| | - Christian H Kristensen
- Centre of Studies and Research in Traumatic Stress, Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Frank Neuner
- Department of Clinical Psychology and Psychotherapy, Bielefeld University, Bielefeld, Germany
| | - Misari Oe
- Department of Neuropsychiatry, Kurume University School of Medicine, Fukuoka, Japan
| | - William Yule
- Department of Applied Child Psychology, King's College, London, UK
| |
Collapse
|