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Berthail B, Trousselard M, Lecouvey G, Le Roy B, Fraisse F, Peschanski D, Eustache F, Gagnepain P, Dayan J. Differences in predictive factors for post-traumatic stress disorder encompassing partial PTSD and full PTSD: a cross-sectional study among individuals exposed to the November 13, 2015 Paris attacks. Front Psychiatry 2024; 15:1351695. [PMID: 38606406 PMCID: PMC11007703 DOI: 10.3389/fpsyt.2024.1351695] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2023] [Accepted: 02/26/2024] [Indexed: 04/13/2024] Open
Abstract
Background When faced with a surge of physically injured individuals, especially following a traumatic event like an attack, frontline practitioners prioritize early triage. Detecting potential psychological injuries soon after such events remains challenging. Some individuals might develop post-traumatic stress disorder (PTSD) according to DSM-V criteria. Others may exhibit PTSD symptoms without meeting full diagnostic criteria, termed partial or sub-syndromal PTSD, a less-explored area in literature. This study aims to identify predictive factors for both full and partial PTSD. Method In a cohort of victims of the 2015 Paris attacks, multinomial logistic regressions explored predictive factors for partial or full PTSD status 8 to 18 months post-attacks. Analyses considered pre, peri, and posttraumatic factors chosen from literature review and univariate analysis within each group. Results Within the cohort, 50 individuals showed no signs of PTSD, 35 experienced partial PTSD, and 30 presented with full PTSD. After logistic regression, risk factors associated with full PTSD included a history of trauma (OR = 1.30, CI [1.02-1.66], p < 0.05), the intensity of peri-traumatic physical reactions (OR = 1.22, CI [1.09-1.36], p < 0.001), the difficulties in suppressing intrusive thoughts (OR = 1.11, CI [1.02-1.21], p < 0.013). Only the intensity of peri-traumatic physical reactions emerged as a risk factor for partial PTSD (OR = 1.13, [CI 1.02-1.24], p < 0.001). Discussion This study revealed that a history of trauma, the intensity of peri-traumatic physical reactions (e.g., tachycardia, trembling, flushes, numbness.), and the difficulties in suppressing intrusive thoughts constitute risk factors for the development of full PTSD. Moreover, the study identified that only the intensity of peri-traumatic physical reactions emerged as a risk factor for partial PTSD. These findings seem to underscore the significance of peri-traumatic experiences in influencing the development of post-traumatic stress symptoms. Conclusion This study emphasizes the significance of examining peri-traumatic reactions in PTSD development, suggesting its potential as a straightforward screening tool for post-traumatic stress disorder. It also underscores the influence of prior traumatic experiences, before de novo traumatization, in shaping vulnerability to PTSD and illuminates the crucial role of compromised control of intrusive thoughts that could perpetuate PTSD.
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Affiliation(s)
- Benoit Berthail
- French Military Health Service Academy, Ecole du Val de Grace, 1 Place Alphonse Laveran, Paris, France
- Neuropsychology and Imaging of Human Memory (NIMH) Research Unit, GIP Cyceron, INSERM U1077, Caen University Hospital, PSL, EPHE, Caen University, Caen, France
| | - Marion Trousselard
- Stress Neurophysiology Unit, French Armed Forces Biomedical Research Institute, Brétigny-sur-Orge, France
- University of Lorraine, Inserm, INSPIIRE UMR 1319, F-54000, Nancy, France
| | - Gregory Lecouvey
- Neuropsychology and Imaging of Human Memory (NIMH) Research Unit, GIP Cyceron, INSERM U1077, Caen University Hospital, PSL, EPHE, Caen University, Caen, France
| | - Barbara Le Roy
- Stress Neurophysiology Unit, French Armed Forces Biomedical Research Institute, Brétigny-sur-Orge, France
| | - Florence Fraisse
- Neuropsychology and Imaging of Human Memory (NIMH) Research Unit, GIP Cyceron, INSERM U1077, Caen University Hospital, PSL, EPHE, Caen University, Caen, France
| | - Denis Peschanski
- Paris I Pantheon Sorbonne University, HESAM University , EHESS, CNRS, UMR8209, Paris, France
| | - Francis Eustache
- Neuropsychology and Imaging of Human Memory (NIMH) Research Unit, GIP Cyceron, INSERM U1077, Caen University Hospital, PSL, EPHE, Caen University, Caen, France
| | - Pierre Gagnepain
- Neuropsychology and Imaging of Human Memory (NIMH) Research Unit, GIP Cyceron, INSERM U1077, Caen University Hospital, PSL, EPHE, Caen University, Caen, France
| | - Jacques Dayan
- Neuropsychology and Imaging of Human Memory (NIMH) Research Unit, GIP Cyceron, INSERM U1077, Caen University Hospital, PSL, EPHE, Caen University, Caen, France
- Child and Adolescent Psychiatry University Hospital Pole, Guillaume Régnier Hospital Center, Rennes 1 University, 35700 Rennes, France
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Giaume L, Le Roy B, Daniel Y, Lauga Cami H, Jost D, Travers S, Trousselard M. Psychological, cognitive, and physiological impact of hazards casualties' trainings on first responders: the example of a chemical and radiological training. An exploratory study. Front Psychol 2024; 15:1336701. [PMID: 38352026 PMCID: PMC10861781 DOI: 10.3389/fpsyg.2024.1336701] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2023] [Accepted: 01/15/2024] [Indexed: 02/16/2024] Open
Abstract
Background First responders are among the first to respond to hazards casualties. They might operate in volatile, uncertain, complex, and ambiguous (VUCA) environments. While they have underlined the need to improve their knowledge and training to face these environments, there are few data regarding the stress induced by these trainings. Chemical, biological, radiological, and nuclear (CBRN) hazards casualties' trainings seem to be a good model of "in vivo" stress. First responders must operate in a hostile and encountered environment with a CBRN protective equipment that places demand on their psychological, cognitive, and physiological capacities. Current research recognizes that the activity of the parasympathetic system (PSS) can be used as an objective marker of stress adaptation, measured as heart rate variability (HRV). Objectives To compare between baseline and simulation the evolution of the parasympathetic activity (primary outcome), anxiety, emotions, cognitive load, and body posture awareness (secondary outcomes). Methods A total of 28 first responders attended to three simulated scenarios requiring CBRN management of casualties. One day before simulation, we collected HRV data (baseline). The simulations' day (pre-, post-simulation) we collected anxiety score (STAI-Y B), emotions (SPANE), cognitive load (NASA TLX), body posture awareness (PAS) and HRV. The morning after we collected the PAS score (recovery). We compare data' evolution between different times of the simulation. Results (i) A high level of anxiety at baseline [Median 51 (46; 56)] which decreased between pre- and post-simulation (p = 0.04; F = 2.93); (ii) a post-simulation decrease in negative feelings (p = 0.03); (iii) a decrease in body awareness after simulation which returned to the initial level at recovery (p = 0.03; F = 3.48); (iv) a decrease in mean RR between baseline, pre- and post-simulation (p = 0.009; F = 5.11). There were no significant difference between times on others analysis of HRV. Conclusion Prior to simulation, participants experienced anticipatory anxiety. Simulations training practiced regularly could be one way to combat anticipatory anxiety.
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Affiliation(s)
- Louise Giaume
- Emergency Medical Department, Paris Fire Brigade, Paris, France
- French Military Biomedical Research, Brétigny-sur-Orge, France
| | | | - Yann Daniel
- Emergency Medical Department, Paris Fire Brigade, Paris, France
| | | | - Daniel Jost
- Emergency Medical Department, Paris Fire Brigade, Paris, France
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Le Roy B, Martin-Krumm C, Poupon C, Richieri R, Malbos E, Barthélémy F, Guedj E, Trousselard M. Virtual Exercise in Medicine: A Proof of Concept in a Healthy Population. JMIR Form Res 2024; 8:e45637. [PMID: 38252484 PMCID: PMC10845022 DOI: 10.2196/45637] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Revised: 05/19/2023] [Accepted: 08/31/2023] [Indexed: 01/23/2024] Open
Abstract
BACKGROUND Science is beginning to establish the benefits of the use of virtual reality (VR) in health care. This therapeutic approach may be an appropriate complementary treatment for some mental illnesses. It could prevent high levels of morbidity and improve the physical health of patients. For many years, the literature has shown the health benefits of physical exercise. Physical exercise in a VR environment may improve the management of mild to moderate mental health conditions. In this context, we developed a virtual environment combined with an ergocycle (the augmented physical training for isolated and confined environments [APTICE] system). OBJECTIVE This study aims to investigate the impact of physical exercise in a VR environment. METHODS A total of 14 healthy participants (11 men and 3 women; mean age 43.28, SD 10.60 years) undertook 15 minutes of immersive physical exercise using the system. Measures included mindfulness and immersion disposition, subjective perceptions of sensory information, user experience, and VR experience (ie, psychological state, flow, and presence). RESULTS First, the APTICE system appears to be a useful tool because the user experience is positive (subscales in the AttrakDiff questionnaire: pragmatic quality=0.99; hedonic quality-stimulation=1.90; hedonic quality-identification=0.67; attractiveness=1.58). Second, the system can induce a positive psychological state (negative emotion, P=.06) and an experience of flow and presence (P values ranging from <.001 to .04). Third, individual immersive and mindful disposition plays a role in the VR experience (P values ranging from <.02 to .04). Finally, our findings suggest that there is a link between the subjective perception of sensory information and the VR experience (P values ranging from <.02 to .04). CONCLUSIONS These results indicate that the device is well accepted with positive psychological and exteroceptive outcomes. Overall, the APTICE system could be a proof of concept to explore the benefits of virtual physical exercise in clinical medicine.
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Affiliation(s)
- Barbara Le Roy
- Unité neurophysiologie du stress, Institut de recherche biomédicale des armées, Brétigny-sur-Orge, France
- Adaptation, mesure et évaluation en santé. Approches interdisciplinaires, Metz, France
| | - Charles Martin-Krumm
- Unité neurophysiologie du stress, Institut de recherche biomédicale des armées, Brétigny-sur-Orge, France
- Adaptation, mesure et évaluation en santé. Approches interdisciplinaires, Metz, France
- Vulnérabilité, capabilité, rétablissement, Unité religion, culture et société, Ecole des psychologues praticiens, Paris, France
| | - Charlotte Poupon
- École nationale supérieure de création industrielle, Paris, France
| | - Raphaëlle Richieri
- Département psychiatrie, Hôpital de la Conception, Institut Fresnel, Marseille, France
| | - Eric Malbos
- Département psychiatrie, Hôpital de la Conception, Institut Fresnel, Marseille, France
| | - Fanny Barthélémy
- Département de médecine nucléaire, Centre européen de recherche en imagerie médicale, Institut Fresnel, Marseille, France
| | - Eric Guedj
- Département de médecine nucléaire, Centre européen de recherche en imagerie médicale, Institut Fresnel, Marseille, France
| | - Marion Trousselard
- Unité neurophysiologie du stress, Institut de recherche biomédicale des armées, Brétigny-sur-Orge, France
- Adaptation, mesure et évaluation en santé. Approches interdisciplinaires, Metz, France
- Service de santé des armées, Paris, France
- Réseau ABC des Psychotraumas, Montpellier, France
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Le Roy B, Martin-Krumm C, Pinol N, Dutheil F, Trousselard M. Human challenges to adaptation to extreme professional environments: A systematic review. Neurosci Biobehav Rev 2023; 146:105054. [PMID: 36682426 DOI: 10.1016/j.neubiorev.2023.105054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Revised: 01/16/2023] [Accepted: 01/17/2023] [Indexed: 01/21/2023]
Abstract
NASA is planning human exploration of the Moon, while preparations are underway for human missions to Mars, and deeper into the solar system. These missions will expose space travelers to unusual conditions, which they will have to adapt to. Similar conditions are found in several analogous environments on Earth, and studies can provide an initial understanding of the challenges for human adaptation. Such environments can be marked by an extreme climate, danger, limited facilities and supplies, isolation from loved ones, or mandatory interaction with others. They are rarely encountered by most human beings, and mainly concern certain professions in limited missions. This systematic review focuses on professional extreme environments and captures data from papers published since 2005. Our findings provide an insight into their physiological, biological, cognitive, and behavioral impacts for better understand how humans adapt or not to them. This study provides a framework for studying adaptation, which is particularly important in light of upcoming longer space expeditions to more distant destinations.
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Affiliation(s)
- Barbara Le Roy
- Stress Neurophysiology Unit, French Armed Forces Biomedical Research Institute, Brétigny-sur-Orge Cedex, France; CNES, Paris, France; APEMAC/EPSAM, EA 4360 Metz Cedex, France.
| | - Charles Martin-Krumm
- Stress Neurophysiology Unit, French Armed Forces Biomedical Research Institute, Brétigny-sur-Orge Cedex, France; APEMAC/EPSAM, EA 4360 Metz Cedex, France; École de Psychologues Praticiens, Catholic Institute of Paris, EA Religion, Culture et société, Paris, France
| | - Nathalie Pinol
- Université Clermont Auvergne, Health Library, Clermont-Ferrand, France
| | - Frédéric Dutheil
- University Hospital of Clermont-Ferrand, CHU Clermont-Ferrand, Occupational and Environmental Medicine, WittyFit, F 63000 Clermont-Ferrand, France; Université Clermont Auvergne, CNRS, LaPSCo, Physiological and Psychosocial Stress, 34 Avenue Carnot, 63 037 Clermont-Ferrand, France
| | - Marion Trousselard
- Stress Neurophysiology Unit, French Armed Forces Biomedical Research Institute, Brétigny-sur-Orge Cedex, France; APEMAC/EPSAM, EA 4360 Metz Cedex, France; French Military Health Service Academy, Paris, France
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Abstract
The effect of the metabotropic glutamate receptor agonist trans-1-amino-1,3,cyclopentanedicarboxylic acid (trans-ACPD) on epileptiform activity induced in rat neocortical slices by exposure to Mg(2+)-free medium was examined. Trans-ACPD dose dependently (10-200 microM) decreased the frequency of spontaneous epileptiform events whilst increasing both the duration of afterpotentials and the number of afterbursts associated with single events. This effect on afterpotentials and afterbursting was particularly pronounced in 14-17 day-old rats and was blocked by the sigma ligand ditolyguanidine (DTG) 10 microM. The putative metabotropic glutamate receptor antagonist L-AP3 did not antagonise the actions of trans-ACPD. The results suggest a role for metabotropic glutamate receptors in epilepsy, possibly in the transition from interictal to ictal activity.
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Acharya GS, Nayak SK, Das BK, Das K, Roy BL. Cytodiagnosis of primary malignant melanoma at unusual sites. Indian J Cancer 1982; 19:35-9. [PMID: 7106830] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
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