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Isobel S, Emerton A, Lim-Gibson S. Birth trauma in a population requiring inpatient mental health care in the postpartum period. Australas Psychiatry 2024:10398562241246150. [PMID: 38616574 DOI: 10.1177/10398562241246150] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/16/2024]
Abstract
OBJECTIVE This study explores rates of birth-related symptoms of trauma in a population of parents experiencing severe perinatal mental illness. METHOD Birthing-parents admitted to a perinatal inpatient unit completed birth trauma measures on admission which were descriptively analyzed. RESULTS The population had higher rates of birth-related potentially traumatic events and trauma-related symptoms than the general population. CONCLUSIONS The findings highlight that assessing for and responding to experiences of birth trauma is highly relevant to an inpatient perinatal population.
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Affiliation(s)
- Sophie Isobel
- Naamuru Parent and Baby Unit, Sydney Local Health District, Camperdown, NSW, Australia; and
- Faculty of Medicine and Health, University of Sydney, Camperdown, NSW, Australia
| | - Alexandra Emerton
- Naamuru Parent and Baby Unit, Sydney Local Health District, Camperdown, NSW, Australia
| | - Sylvia Lim-Gibson
- Naamuru Parent and Baby Unit, Sydney Local Health District, Camperdown, NSW, Australia
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Arcan C, Hou W, Hoffman K, Reichardt A, Yang X, Clouston SAP, Bromet EJ, Luft B. Mediterranean diet intervention among World Trade Center responders with post-traumatic stress disorder: Feasibility and outcomes of a pilot randomized controlled trial. Obes Sci Pract 2024; 10:e725. [PMID: 38263989 PMCID: PMC10804354 DOI: 10.1002/osp4.725] [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] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2023] [Revised: 11/08/2023] [Accepted: 11/13/2023] [Indexed: 01/25/2024] Open
Abstract
Objective Responders of the World Trade Center (WTC) disaster suffer from co-morbidities. A Mediterranean Diet (MedDiet) nutrition intervention with physical activity was implemented among WTC responders with overweight/obesity and post-traumatic stress disorder (PTSD). Methods WTC Health Program members (N = 62), 45-65 years, males 87%, body mass index (BMI) 27-45 kg/m2 randomized to MedDiet (n = 31) or usual nutrition counseling (n = 31). The 10-week intervention included online nutrition education, text messages, and group experiential cooking; both groups had three in-person individual nutrition counseling. Anthropometrics, serum biomarkers, psychosocial factors, MedDiet score, and PTSD symptoms were assessed at baseline, post-intervention, and 3-months (follow-up). The primary outcome was intervention feasibility and secondary outcomes were within- and between-group changes of all measures at post-intervention and follow-up. Nonparametric Wilcoxon rank sum tests for between-group comparisons and Wilcoxon signed rank tests for pre-post within-group comparisons. Results A total of 58(94%) and 46(74%) participants completed the post-intervention and follow-up measurements, respectively. Both groups experienced significant improvements in anthropometrics, MedDiet score, oxidized low-density lipoprotein, and PTSD symptoms. Baseline median (range) were weight 100.42 (73.66-135.17) kg, BMI 33.20 (27.50-41.75) kg/m2, and Waist circumference (WC) 109.22 (90.17-150.62) cm. Median % weight loss at post-intervention was MedDiet: -3% (-11%-7%), p = 0.0002; Control: -1% (-13%-4%), p = 0.008 and at follow-up MedDiet: -2% (-14%-12%), p = 0.07; Control: -2% (-20%-3%), p = 0.006. The overall BMI was reduced by -0.68 kg/m2 (-4.61-2.09) kg/m2 p < 0.0001 at post-intervention and by -0.60 kg/m2 (-6.91-3.39) kg/m2, p < 0.0009 at follow-up. Overall, median WC was reduced (p < 0.0001); post-intervention -3.81 cm (-33.00-3.30)cm and follow-up -4.45(-38.10-4.57)cm. There were group differences in HbA1c (p = 0.019) and serum ω6/ω3 (p = 0.029) at post-intervention. Conclusion Online intervention with personal counseling was feasible in this population. Improvements in anthropometrics, MedDiet score, selected serum biomarkers and PTSD symptoms were found in both groups; group differences in HbA1c and serum ω6/ω3. A larger study with a delayed control is needed to better assess intervention effects.
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Affiliation(s)
- Chrisa Arcan
- Department of EpidemiologySchool of Population HealthVirginia Commonwealth UniversityRichmondVirginiaUSA
- Department of FamilyPopulation and Preventive MedicineRenaissance School of MedicineStony Brook UniversityStony BrookNew YorkUSA
| | - Wei Hou
- Department of FamilyPopulation and Preventive MedicineRenaissance School of MedicineStony Brook UniversityStony BrookNew YorkUSA
- Vertex Pharmaceuticals IncorporatedBostonMassachusettsUSA
| | - Kathryn Hoffman
- Stony Brook World Trade Center Health Plan and Wellness ProgramRenaissance School of MedicineStony Brook UniversityCommackNew YorkUSA
| | - Amanda Reichardt
- Stony Brook World Trade Center Health Plan and Wellness ProgramRenaissance School of MedicineStony Brook UniversityCommackNew YorkUSA
| | - Xiaohua Yang
- Stony Brook World Trade Center Health Plan and Wellness ProgramRenaissance School of MedicineStony Brook UniversityCommackNew YorkUSA
| | - Sean A. P. Clouston
- Department of FamilyPopulation and Preventive MedicineRenaissance School of MedicineStony Brook UniversityStony BrookNew YorkUSA
| | - Evelyn J. Bromet
- Neurosciences InstituteRenaissance School of MedicineStony Brook UniversityStony BrookNew YorkUSA
| | - Benjamin Luft
- Stony Brook World Trade Center Health Plan and Wellness ProgramRenaissance School of MedicineStony Brook UniversityCommackNew YorkUSA
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Ahmed MM, John J. Perceptions of mental health services among the children who are in conflict with the law in Jammu and Kashmir. Glob Ment Health (Camb) 2023; 10:e81. [PMID: 38161739 PMCID: PMC10755411 DOI: 10.1017/gmh.2023.70] [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: 01/05/2023] [Revised: 10/05/2023] [Accepted: 10/31/2023] [Indexed: 01/03/2024] Open
Abstract
Background: Due to the Jammu and Kashmir conflict, many teenagers are involved in disputes with the law. The conflict made generations suffer for decades. Such children made the mobs; being involved in life-threatening situations and the risk they confront develop psychiatric disorders. As a result of the various tense conditions when applied in multiple anti-social activities, aberrant children sent to correctional homes have to encounter numerous psychological disorders. Aim: The motive of the study is to explore the level of awareness, availability of services, stigma and obstacles to seeking assistance. Method: Due to the open-ended interview questions and a small sample size of 15 respondents, this study employed a qualitative methodology - a thematic analysis was done. Results: The findings revealed that, although the stigma is not publicly acknowledged, children who break the law and seek mental health services (MHS) are stigmatised. It was also shown that minor offenders fear that when they receive services provided by the staff of the observation home (OH), there will be a violation of their privacy and fear unforeseen repercussions. Conclusion: Collaborative action must proactively raise appropriate awareness to lessen the stigma linked with mental health problems, especially regarding MHS among these teenagers.
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Affiliation(s)
- Mohd Manshoor Ahmed
- Research Scholar, Department of Social Work, Central University of Kerala, Periye, Kerala
| | - Jilly John
- Assistant Professor, Department of Social Work, Central University of Kerala, Periye, Kerala
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Block T, Kuo J, Green M. Pulsed Radiofrequency-Enhanced Dual Sympathetic Block for the Treatment of Post-Traumatic Stress Disorder. Cureus 2023; 15:e41309. [PMID: 37539404 PMCID: PMC10395396 DOI: 10.7759/cureus.41309] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/03/2023] [Indexed: 08/05/2023] Open
Abstract
Dual sympathetic blocks (DSBs) have been shown to provide significant symptom relief in individuals with post-traumatic stress disorder (PTSD). However, despite the clinical significance of DSB in PTSD treatment, a subset of patients experience the recurrence of somatic symptoms of PTSD and trauma-induced anxiety. The purpose of this case report is to describe our experience with the successful treatment of acute symptoms of PTSD by using serial DSBs and DSBs with pulsed radiofrequency (PRF). An 18-year-old male who had suffered multiple childhood traumatic events presented with severe and persistent symptoms consistent with a diagnosis of PTSD. The patient had been previously treated with myriad, multiple-year trials of psychotropic medications and psychotherapy as well as lifestyle modifications involving art therapy and physical exercise. Despite these psychiatric and psychological interventions, his symptoms persisted. The patient underwent a total of four bilateral DSBs, three of which were enhanced with PRF, over a period of 15 months at our clinic, with intervals of three, four, and six months between appointments, respectively. At the two-week follow-up after the initial bilateral stellate ganglion block (SGB) procedure, a major improvement in the patient's PTSD symptoms was observed, specifically symptoms of anxiety and a heightened sense of danger. These results were confirmed by a reduction in PTSD Checklist Version 5 (PCL-5) scores from 73 to 50. However, three months later, some of his symptoms returned. The patient elected to proceed with a bilateral PRF-enhanced DSB, and he subsequently reported that his PTSD and general anxiety symptoms subsided by 80%, which was confirmed by a reduction in PCL-5 scores from 50 to 42. This significant symptom relief persisted for four months, and the patient returned for his second bilateral PRF-enhanced DSB. The patient's PCL-5 score further dropped from 42 to 22 and he reported an 80% reduction in symptoms, which persisted for six months. The patient elected to undergo a third bilateral PRF-enhanced DSB, which was successful in further reducing his symptoms as demonstrated by a self-reported 80% symptom relief and a drop in PCL-5 scores from 22 to 20, which has persisted for over six months. We highlight the fact that the addition of PRF in a selective blockade of the stellate ganglion via injection reduced our patient's PTSD symptoms to below the PTSD diagnostic threshold. Furthermore, we report that the clinical efficacy of bilateral PRF-enhanced DSB may be additive over successive procedures. We also provide a theoretical exposition of our findings.
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Affiliation(s)
| | - Jonathann Kuo
- Regenerative and Anti-Aging Medicine, Hudson Medical Group, New York, USA
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Saleem F, Malik MI. Exposure to Terrorism, Post-Traumatic Stress Disorder and University Teachers' Performance: Underpinning the Role of Social Support. Behav Sci (Basel) 2023; 13:517. [PMID: 37366769 PMCID: PMC10294798 DOI: 10.3390/bs13060517] [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: 03/04/2023] [Revised: 06/02/2023] [Accepted: 06/07/2023] [Indexed: 06/28/2023] Open
Abstract
This study aims to investigate the impact of exposure to terrorism on post-traumatic stress disorder and employee performance, and to determine whether social support acts as a boundary condition that can attenuate the adverse effects of PTSD on employee performance. The study used a cross-sectional sample of 178 university teachers who had experienced a terrorist attack. Data was collected using closed-ended questionnaires and analyzed using PROCESS Macro). The results found a negative and significant relationship between exposure to terrorism, post-traumatic disorder, and employees' performance. Moreover, it was also found that social support helps attenuate the negative impact of PTSD on performance levels. This study adds to the existing body of knowledge by exploring the relationship between terrorism exposure, PTSD, employee performance, and the potential mitigating effects of social support.
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Affiliation(s)
- Farida Saleem
- Department of Management, College of Business Administration, Prince Sultan University, Riyadh 11586, Saudi Arabia
| | - Muhammad Imran Malik
- Department of Management Sciences, COMSATS University Islamabad, Attock Campus, Attock 43600, Pakistan
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Wang L, Fang R, Chen C, Cao C. A comparison of ICD-11 and DSM-5 criteria of PTSD among Chinese trauma-exposed adolescent samples. Front Psychiatry 2023; 14:1186138. [PMID: 37383620 PMCID: PMC10293836 DOI: 10.3389/fpsyt.2023.1186138] [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] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Accepted: 05/23/2023] [Indexed: 06/30/2023] Open
Abstract
This study aimed at comparing the prevalence and comorbidity differences of PTSD according to ICD-11 and DSM-5 definitions across two Chinese adolescent trauma-exposed samples. A total of 1,201 students exposed to earthquake and 559 students from vocational schools exposed to potentially traumatic events were included in this study. The PTSD Checklist for DSM-5 was used to measure PTSD symptoms. The MDD and GAD subscales of the Revised Children's Anxiety and Depression Scale were used to measure major depression disorder (MDD) and generalized anxiety disorder (GAD) symptoms. No significant PTSD prevalence differences between ICD-11 and DSM-5 were found across the two samples. The differences regarding comorbidities between ICD-11 and DSM-5 definitions were not significant among these two samples. The results revealed that the ICD-11 and DSM-5 provided similar prevalence of PTSD and comorbidity rates with MDD and GAD in Chinese trauma-exposed adolescent samples. This study contributes to the current understanding of the similarities and differences using different PTSD criteria and informs the organization and application of these two globally applied PTSD criteria.
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Affiliation(s)
- Li Wang
- Laboratory for Traumatic Stress Studies, CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China
- Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Ruojiao Fang
- Laboratory for Traumatic Stress Studies, CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China
- Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Chen Chen
- Laboratory for Traumatic Stress Studies, CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China
- Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Chengqi Cao
- Laboratory for Traumatic Stress Studies, CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China
- Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
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Havermans DC, van Alphen SP, Olff M, Van der Velden-Daamen M, Verhey F, Rutten BP, Stuijts P, Cook JM, Sobczak S. The Need for a Diagnostic Instrument to Assess Post-Traumatic Stress Disorder in People with Dementia: Findings from a Delphi Study. J Geriatr Psychiatry Neurol 2023; 36:129-142. [PMID: 35713096 PMCID: PMC9941654 DOI: 10.1177/08919887221103583] [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] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Cognitive and behavioral aspects may mask posttraumatic stress disorder (PTSD) in people with dementia. PTSD severely lowers quality of life in people with dementia. Proper recognition of PTSD is essential to ensure adequate treatment. However, a valid diagnostic tool for PTSD in dementia is lacking. A Delphi study was conducted among 20 Dutch and 6 international experts in the field of PTSD and dementia care or research. The aim was to reach consensus in 3 rounds on the added value, form, content, and application for developing such an instrument. The first round confirmed the need for a new diagnostic tool for research and clinical practice. Consensus was reached on 23 statements regarding the support base and 19 related to content of the instrument. In the third round, opinions on several conceptual problems were gathered. Based on the experts' opinions, a draft version of an instrument, the TRAuma and DEmentia-interview (TRADE-interview), was developed. Clinical and research implications of this new measure are discussed.
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Affiliation(s)
- Demi C.D. Havermans
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience (MHeNs), Maastricht University Medical Centre+, Maastricht, The Netherlands
- Department of Old Age Psychiatry, Mondriaan Mental Health Center, Heerlen, The Netherlands
- Demi C.D. Havermans, MSc, Department of Old Age Psychiatry, Mondriaan Mental Health Center, Heerlen, The Netherlands. Kloosterkensweg 10, 6419PJ Heerlen.
| | - Sebastiaan P.J. van Alphen
- Department of Old Age Psychiatry, Mondriaan Mental Health Center, Heerlen, The Netherlands
- Department of Clinical and Life Span Psychology, Vrije Universiteit Brussel (VUB), Brussels, Belgium
- Department of Medical and Clinical Psychology, School of Social and Behavioral Sciences, Tilburg University, Tilburg, The Netherlands
| | - Miranda Olff
- ARQ National Psychotrauma Centre, Diemen, The Netherlands
- Department of Psychiatry, Amsterdam Public Health, Amsterdam University Medical Centers Location AMC, Amsterdam, The Netherlands
| | - Mariëlle Van der Velden-Daamen
- Department of Health Services Research, Maastricht University, Maastricht, The Netherlands
- Department of Psychogeriatrics, Cicero-Zorggroep, Brunssum, The Netherlands
| | - Frans Verhey
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience (MHeNs), Maastricht University Medical Centre+, Maastricht, The Netherlands
| | - Bart P.F. Rutten
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience (MHeNs), Maastricht University Medical Centre+, Maastricht, The Netherlands
| | | | - Joan M Cook
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
| | - Sjacko Sobczak
- Department of Old Age Psychiatry, Mondriaan Mental Health Center, Heerlen, The Netherlands
- Department of Neuropsychology and Psychopharmacology, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, The Netherlands
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Jin F, Ashraf AA, Ul Din SM, Farooq U, Zheng K, Shaukat G. Corrigendum: Organisational caring ethical climate and its relationship with workplace bullying and post traumatic stress disorder: The role of type A/B behavioural patterns. Front Psychol 2023; 14:1137029. [PMID: 36760427 PMCID: PMC9905830 DOI: 10.3389/fpsyg.2023.1137029] [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: 01/03/2023] [Accepted: 01/05/2023] [Indexed: 01/26/2023] Open
Abstract
[This corrects the article DOI: 10.3389/fpsyg.2022.1042297.].
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Affiliation(s)
- Fang Jin
- School of Management, Wuhan Polytechnic University, Wuhan, China
| | - Ahsan Ali Ashraf
- Department of Business Administration, University of Sialkot, Sialkot, Pakistan
| | - Sajid Mohy Ul Din
- Department of Business Education, University of Lahore, Lahore, Pakistan,Department of Business Education, University of Chenab, Gujrat, Pakistan
| | - Umar Farooq
- FAST School of Management, National University of Computer and Emerging Sciences, Faisalabad, Pakistan
| | - Kengcheng Zheng
- School of Finance and Taxation, Zhongnan University of Economics and Law, Wuhan, China,*Correspondence: Kengcheng Zheng ✉
| | - Ghazala Shaukat
- Department of Sociology, University of Sindh, Jamshoro, Pakistan
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Ziobrowski HN, Holt-Gosselin B, Petukhova MV, King AJ, Lee S, House SL, Beaudoin FL, An X, Stevens JS, Zeng D, Neylan TC, Clifford GD, Linnstaedt SD, Germine LT, Bollen KA, Rauch SL, Haran JP, Storrow AB, Lewandowski C, Musey PI, Hendry PL, Sheikh S, Jones CW, Punches BE, Kurz MC, Swor RA, Hudak LA, Pascual JL, Seamon MJ, Harris E, Pearson C, Merchant RC, Domeier RM, Rathlev NK, O'Neil BJ, Sergot P, Sanchez LD, Bruce SE, Miller MW, Pietrzak RH, Joormann J, Barch DM, Pizzagalli DA, Harte SE, Elliott JM, Ressler KJ, McLean SA, Koenen KC, Kessler RC. Childhood adversities and risk of posttraumatic stress disorder and major depression following a motor vehicle collision in adulthood. Epidemiol Psychiatr Sci 2023; 32:e1. [PMID: 36624694 DOI: 10.1017/S2045796022000798] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
AIMS Childhood adversities (CAs) predict heightened risks of posttraumatic stress disorder (PTSD) and major depressive episode (MDE) among people exposed to adult traumatic events. Identifying which CAs put individuals at greatest risk for these adverse posttraumatic neuropsychiatric sequelae (APNS) is important for targeting prevention interventions. METHODS Data came from n = 999 patients ages 18-75 presenting to 29 U.S. emergency departments after a motor vehicle collision (MVC) and followed for 3 months, the amount of time traditionally used to define chronic PTSD, in the Advancing Understanding of Recovery After Trauma (AURORA) study. Six CA types were self-reported at baseline: physical abuse, sexual abuse, emotional abuse, physical neglect, emotional neglect and bullying. Both dichotomous measures of ever experiencing each CA type and numeric measures of exposure frequency were included in the analysis. Risk ratios (RRs) of these CA measures as well as complex interactions among these measures were examined as predictors of APNS 3 months post-MVC. APNS was defined as meeting self-reported criteria for either PTSD based on the PTSD Checklist for DSM-5 and/or MDE based on the PROMIS Depression Short-Form 8b. We controlled for pre-MVC lifetime histories of PTSD and MDE. We also examined mediating effects through peritraumatic symptoms assessed in the emergency department and PTSD and MDE assessed in 2-week and 8-week follow-up surveys. Analyses were carried out with robust Poisson regression models. RESULTS Most participants (90.9%) reported at least rarely having experienced some CA. Ever experiencing each CA other than emotional neglect was univariably associated with 3-month APNS (RRs = 1.31-1.60). Each CA frequency was also univariably associated with 3-month APNS (RRs = 1.65-2.45). In multivariable models, joint associations of CAs with 3-month APNS were additive, with frequency of emotional abuse (RR = 2.03; 95% CI = 1.43-2.87) and bullying (RR = 1.44; 95% CI = 0.99-2.10) being the strongest predictors. Control variable analyses found that these associations were largely explained by pre-MVC histories of PTSD and MDE. CONCLUSIONS Although individuals who experience frequent emotional abuse and bullying in childhood have a heightened risk of experiencing APNS after an adult MVC, these associations are largely mediated by prior histories of PTSD and MDE.
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Glynn H, Knowles SR. A Phenomenological Investigation of Trauma in 18 Adults Living With Inflammatory Bowel Disease. Clin Nurs Res 2023; 32:159-170. [PMID: 35156407 DOI: 10.1177/10547738221075649] [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] [Indexed: 12/15/2022]
Abstract
While trauma is recognized as being common in Inflammatory Bowel Disease (IBD) cohorts, limited research has explored how trauma impacts the lived experience of IBD. The aim of this study was to develop an understanding of how trauma impacts the experience of living with IBD and its subsequent management. An interpretative phenomenological analysis with thematic analysis was conducted. Eighteen adults with IBD participated in this qualitative research study. Key themes identified included: (1) Trauma was associated with the journey of IBD; (2) the impact of IBD and trauma, and (3) coping strategies. Pre-existing non-IBD trauma was prevalent, with several participants reporting links between traumatic events and their IBD diagnosis. Experiences of IBD trauma were described by participants across all stages of their illness journey. The study can assist healthcare professionals to better understand the experience of living with IBD and trauma and the factors that can contribute to traumatic responses.
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Affiliation(s)
- Heidi Glynn
- Swinburne University of Technology, Melbourne, Australia
| | - Simon R Knowles
- Swinburne University of Technology, Melbourne, Australia.,St Vincent's Hospital, Melbourne, Australia.,Department of Medicine, The University of Melbourne, Australia
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Muacevic A, Adler JR. Application of Deep Brain Stimulation in Refractory Post-Traumatic Stress Disorder. Cureus 2023; 15:e33780. [PMID: 36819333 PMCID: PMC9928537 DOI: 10.7759/cureus.33780] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Accepted: 01/14/2023] [Indexed: 01/16/2023] Open
Abstract
Post-traumatic stress disorder (PTSD) is a mental disorder that produces crippling anxiety and occurs in response to an extreme, traumatic stressor. Compared to the prevalence of PTSD in the general population, the prevalence of PTSD in at-risk populations (e.g., army veterans, those affected by environmental calamities, and others) can reach up to threefold. The conventional treatment of PTSD involves using SSRIs (serotonin reuptake inhibitors) and other anti-depressants along with psychotherapy such as debriefing and CBT (cognitive behavioral therapy). Due to increasing resistance to conventional treatment, more novel treatment options, such as stellate ganglion block shots and neuromodulation, are being explored. These neuromodulation techniques include transcranial magnetic stimulation (TMS), transcranial direct current stimulation (TDS), and deep brain stimulation (DBS). The rationale behind employing these techniques in refractory PTSD is the altered neurocircuitry seen in PTSD patients, which can be visualized on imaging. Studies involving the use of DBS for PTSD primarily target specific areas in the brain: the amygdala, the prefrontal cortex, the hippocampus, and the hypothalamus. This article aims to provide a brief overview of the various neuromodulation techniques currently employed in the management of treatment-resistant PTSD and an in-depth review of the available literature on animal models in which DBS for PTSD has been researched. We also shed light on the human clinical trials conducted for the same.
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Jin F, Ashraf AA, Ul Din SM, Farooq U, Zheng K, Shaukat G. Organisational caring ethical climate and its relationship with workplace bullying and post traumatic stress disorder: The role of type A/B behavioural patterns. Front Psychol 2022; 13:1042297. [PMID: 36405171 PMCID: PMC9667947 DOI: 10.3389/fpsyg.2022.1042297] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Accepted: 09/26/2022] [Indexed: 11/07/2022] Open
Abstract
A multifaceted, holistic approach to identifying potential predictors is needed to eradicate workplace bullying. The current study investigated the impact of an unfavourable organisational climate that plays a role in breeding workplace bullying (social stressors). The present study also postulated that individual personality differences (Type A and Type B personality) mediate between a caring climate and workplace bullying. Similarly, the interaction between workplace bullying and personality impacts PTSD. We also checked the role of workplace bullying as a mediator between a caring climate and PTSD. This research tested all the proposed hypotheses (N = 298), and the study was conducted in Pakistan. The data is analysed using the two-step partial least square structural equation modelling (PLS-SEM) procedure. The first part assesses the measurement model, while in the second step, the structural model is evaluated. The results supported all the proposed hypotheses of this study. Type A behaviour moderated the caring climate-person-related bullying relationship, whereas it did not moderate the caring climate-work-related bullying in the suggested direction. Type A behaviour is moderated for both types of bullying and PTSD. Results also show significant indirect effects of a caring climate on PTSD through workplace bullying. This study will contribute theoretically to filling the literature gap on studies of climate-bullying and bullying-stress using contingency factors.
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Affiliation(s)
- Fang Jin
- School of Management, Wuhan Polytechnic University, Wuhan, China
| | - Ahsan Ali Ashraf
- Department of Business Administration, University of Sialkot, Sialkot, Pakistan
| | - Sajid Mohy Ul Din
- Department of Business Education, University of Lahore, Lahore, Pakistan
- Department of Business Education, University of Chenab, Gujrat, Pakistan
| | - Umar Farooq
- FAST School of Management, National University of Computer and Emerging Sciences, Faisalabad, Pakistan
| | - Kengcheng Zheng
- School of Finance and Taxation, Zhongnan University of Economics and Law, Wuhan, China
| | - Ghazala Shaukat
- Department of Sociology, University of Sindh, Jamshoro, Pakistan
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Muacevic A, Adler JR, Natarajan B, Mitra S, Tango T, Ahmed A, Bansode S, Almushawah AA. Current Treatments of Post-traumatic Stress Disorder and Amygdala Ablation as a Potential Cutting-Edge Therapy in Its Refractory Cases. Cureus 2022; 14:e31943. [PMID: 36582576 PMCID: PMC9794924 DOI: 10.7759/cureus.31943] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/27/2022] [Indexed: 11/29/2022] Open
Abstract
Post-traumatic stress disorder (PTSD)is a very common psychiatric disorder occurring in an individual of any age, gender, or race who underwent trauma, with women being twice more at risk than men. It is generally seen more in American Indians, United States Latinos, and African American ethnic groups. A patient is diagnosed with PTSD if the symptoms of intrusion, avoidance, changes in cognition and emotions, arousal, and mood reactivity changes persist for more than a month and cause the individual severe difficulty in their everyday cognitive and psychological functioning. The psychological treatment includes numerous therapies including trauma-focused therapies such as cognitive behavioral therapy, cognitive processing therapy, prolonged exposure therapy, eye movement desensitization and reprocessing, and non-trauma-focused therapies such as relaxation techniques, interpersonal therapy, and mindfulness. Various pharmacological measures have also been tried with mixed results such as selective serotonin reuptake inhibitors, benzodiazepines, adrenergic drugs, atypical antipsychotics, and mood stabilizers like lithium and valproate. As numerous studies have proven, PTSD is linked with right-side stimulation of the amygdala. The purpose of this article is to highlight the use of extremely selective laser ablation of the amygdala-hippocampal unit as a successful surgical intervention for medically unresponsive PTSD and as a revolutionary solution and prospective cutting-edge therapy in the near future.
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Muacevic A, Adler JR, Al Mazyad B, Al Yousef S, Hatab Alanazi S. The Association Between Post-Traumatic Stress Disorder and Temporomandibular Disorders: A Systematic Review. Cureus 2022; 14:e31896. [PMID: 36579250 PMCID: PMC9792336 DOI: 10.7759/cureus.31896] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Accepted: 11/20/2022] [Indexed: 11/27/2022] Open
Abstract
The purpose of this systematic study was to discover a connection between temporomandibular joint disorders and post-traumatic stress disorder. A systematic review of observational studies on post-traumatic stress disorder and the incidence of temporomandibular joint disorders (TMD) was conducted. Electronic searches of PubMed, the Saudi Digital Library, Science Direct, the Virtual Health Library (VHL), Scopus, Web of Science, Sage, EBSCO Information Services, and Ovid were performed. There was a consensus among the reviewing examiners. Only studies with the following Medical Subject Headings (MeSH) terms were included: "Posttraumatic stress disorder" combined with "temporomandibular joint disorder," "myofascial pain," "orofacial pain," "internal derangement," "disc displacement with reduction," or "disc displacement without reduction." Only full-text studies in the English language published between 2010 and June 2020 were considered. Of a total of 381 articles meeting the initial screening criteria, only eight were included in the qualitative analysis. Overall, pain is exacerbated in patients with PTSD; that is, their TMD is heightened in all aspects of pain, chronicity, decreased response to conventional therapies, and the need for more potent treatment options as compared with patients with just TMD. The evidence, albeit weak, obtained from the studies included in this review suggests a relationship between PTSD and TMDs.
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Muacevic A, Adler JR. The Efficacy of Psychedelic-Assisted Therapy in Managing Post-traumatic Stress Disorder (PTSD): A New Frontier? Cureus 2022; 14:e30919. [PMID: 36465766 PMCID: PMC9710723 DOI: 10.7759/cureus.30919] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/31/2022] [Indexed: 01/25/2023] Open
Abstract
Post-traumatic stress disorder (PTSD) is a significant public health concern for which existing therapies are only marginally effective. Indisputably, the primary line of treatment for PTSD is psychotherapy, according to current treatment guidelines. However, PTSD continues to be a chronic condition even after psychotherapy, with high psychiatric and medical illness rates. There is a dire need to search for new compounds and approaches for managing PTSD. The usage of psychedelic substances is a potential new method. This article reviews the efficacy of psychedelic-assisted therapy in treating PTSD and improving patient outcomes. It will examine current research on the topic and evaluate the benefits and drawbacks of different therapies. The current evidence for the use of four different types of psychedelics (3,4-methylenedioxymethamphetamine, ketamine, classical psychedelics, and cannabis) in the treatment of PTSD will be reviewed. It will also include an overview of the therapeutic justification, context of use, and level of evidence available for each drug. Several questions are formulated that could be studied in future research in order to gain a better understanding of the topic.
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16
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Vanuk JR, Pace-Schott EF, Bullock A, Esbit S, Dailey NS, Killgore WDS. Morning blue light treatment improves sleep complaints, symptom severity, and retention of fear extinction memory in post-traumatic stress disorder. Front Behav Neurosci 2022; 16:886816. [PMID: 36172467 PMCID: PMC9510714 DOI: 10.3389/fnbeh.2022.886816] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Accepted: 08/17/2022] [Indexed: 11/13/2022] Open
Abstract
Disrupted sleep is a major feature in numerous clinical disorders and is related to decrements in affective memory processing. The prevalence of sleep disruption in post-traumatic stress disorder (PTSD) is suggested to be a key feature that exacerbates the impaired ability to recall extinction memories during experimental fear conditioning. We hypothesized that an intervention employing blue-wavelength light therapy (BLT) to regulate sleep and stabilize circadian rhythms in patients with PTSD (i.e., via regulated morning exposure) would be associated with PTSD symptom improvement, decreased sleep-related complaints, as well as improved consolidation and retention of extinction memories relative to a fear conditioning/extinction paradigm. Eighty-two individuals with PTSD underwent a well-validated fear conditioning/extinction protocol with subsequent assignment to receive morning BLUE (BLT) or placebo AMBER (ALT) light therapy daily for 30-min over 6-weeks. Participants returned after the intervention for post-treatment extinction recall, comprised of exposure to the previously conditioned stimuli, with the difference in skin conductance response between the "extinguished" and the "never-extinguished" stimuli at follow-up. Participants also viewed previously conditioned stimuli in a novel context during a functional magnetic resonance imaging (fMRI) scan. BLUE light therapy was associated with improvements relative to correlated decreases between PTSD symptoms and sleep-related complaints. Participants receiving BLT also sustained retention of the extinction memory, while those in the placebo amber light treatment group showed impairment, characterized by the restoration of the extinguished fear response after 6-weeks. Participants in the ALT also demonstrated greater reactivity in the left insula when viewing the previously extinguished fear-conditioned stimuli in a novel context. Daily BLUE-wavelength morning light exposure was associated with greater retention of extinction learning in patients with PTSD when compared to ALT, as supported by both autonomic and neurobiological reactivity. We speculate that improved sleep facilitated by a stabilized circadian rhythm, after fear-learning, led to greater consolidation of the fear extinction memory, decreased PTSD symptom presentation, and associated decreases in sleep-related complaints. Prominent exposure treatments for PTSD incorporate principles of fear extinction, and our findings suggest that blue light treatment may facilitate treatment gains by promoting the consolidation of extinction memories via improved sleep.
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Affiliation(s)
- John R. Vanuk
- Department of Psychiatry, College of Medicine, University of Arizona, Tucson, AZ, United States
| | - Edward F. Pace-Schott
- Massachusetts General Hospital and Harvard Medical School, Charlestown, MA, United States
| | - Ayla Bullock
- Department of Psychiatry, College of Medicine, University of Arizona, Tucson, AZ, United States
| | - Simon Esbit
- Department of Psychiatry, College of Medicine, University of Arizona, Tucson, AZ, United States
| | - Natalie S. Dailey
- Department of Psychiatry, College of Medicine, University of Arizona, Tucson, AZ, United States
| | - William D. S. Killgore
- Department of Psychiatry, College of Medicine, University of Arizona, Tucson, AZ, United States
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17
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Yehene E, Martin Y, Goldzweig G. An Analysis of Factors Predicting Post-Traumatic Stress Disorder and Grief Following Comrade Loss. Omega (Westport) 2022:302228221113616. [PMID: 35837840 DOI: 10.1177/00302228221113616] [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] [Indexed: 06/15/2023]
Abstract
This study explored how "inhibiting factors" associated with military-bereavement impact combatants' psychological sequelae following comrade loss. One hundred six eligible Israeli combat male-soldiers completed the Texas-Revised-Inventory of Grief, the post-traumatic-stress-disorder symptoms scale (PSS), the Male Role Norms Scale, the Social Acknowledgment Questionnaire, and a scale assessing Military Encouragement to Grieve (MEG-8). Time since loss had no impact on soldiers' levels of PSS or prolonged grief. Regression analysis indicated that higher masculinity-perception and disapproval from the family predicated higher PSS, above and beyond grief. Conversely, lower disapproval from the family, and higher disapproval from the general community, predicted higher grief, above and beyond PSS. Also, military encouragement significantly mediated the positive relationship between masculinity and sense of social-recognition. The results show how inhibiting factors contribute differently to the perpetuation of PSS and grief. This interplay sheds light on soldiers' "external" and "internal" loss processes of traumatic bereavement. The practical implications to treatment are also discussed.
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Affiliation(s)
- Einat Yehene
- School of Behavioral Sciences, The Academic College of Tel Aviv-Yaffo, Tel-Aviv Yaffo, Israel
| | - Yossi Martin
- School of Behavioral Sciences, The Academic College of Tel Aviv-Yaffo, Tel-Aviv Yaffo, Israel
| | - Gil Goldzweig
- School of Behavioral Sciences, The Academic College of Tel Aviv-Yaffo, Tel-Aviv Yaffo, Israel
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18
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Ben Assayag E, Tene O, Korczyn AD, Solomon Z, Bornstein NM, Shenhar-Tsarfaty S, Seyman E, Niry D, Molad J, Hallevi H. Posttraumatic Stress Symptoms After Stroke: The Effects of Anatomy and Coping Style. Stroke 2022; 53:1924-1933. [PMID: 35264011 DOI: 10.1161/strokeaha.121.036635] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Posttraumatic stress disorder (PTSD) can be triggered by life-threatening medical emergencies, such as stroke. Data suggest that up to 25% of stroke survivors will develop PTSD symptomatology, but little is known about predisposing factors. We sought to examine whether neuroimaging measures and coping styles are related to PTSD symptoms after stroke. METHODS Participants were survivors of first-ever, mild-moderate ischemic stroke, or transient ischemic attack from the TABASCO study (Tel Aviv Brain Acute Stroke Cohort). All participants underwent a 3T magnetic resonance imaging at baseline and were examined 6, 12, and 24 months thereafter, using neurological, neuropsychological, and functional evaluations. At baseline, coping styles were evaluated by a self-reported questionnaire. PTSD symptoms were assessed using the PTSD checklist. Data were available for 436 patients. RESULTS Forty-eight participants (11%) developed probable PTSD (PTSD checklist ≥44) during the first year after the stroke/transient ischemic attack. Stroke was more likely to cause PTSD than transient ischemic attack. Stroke severity, larger white matter lesion volume, and worse hippocampal connectivity were associated with PTSD severity, while infarct volume or location was not. In a multivariate analysis, high-anxious and defensive coping styles were associated with a 6.66-fold higher risk of developing poststroke PTSD ([95% CI, 2.08-21.34]; P<0.01) compared with low-anxious and repressive coping styles, after adjusting for age, education, stroke severity, brain atrophy, and depression. CONCLUSIONS In our cohort, PTSD was a common sequela among stroke survivors. We suggest that risk factors for PTSD development include stroke severity, white matter damage, and premorbid coping styles. Early identification of at-risk patients is key to effective treatment.
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Affiliation(s)
- Einor Ben Assayag
- Departments of Neurology, Psychiatry and Radiology, Tel Aviv Sourasky Medical Center, Israel (E.B.A., O.T., S.S.-T., E.S., D.N., J.M., H.H.).,Faculty of Medicine, Tel Aviv University, Israel. (E.B.A., O.T., A.D.K., S.S.-T., D.N., H.H.)
| | - Oren Tene
- Departments of Neurology, Psychiatry and Radiology, Tel Aviv Sourasky Medical Center, Israel (E.B.A., O.T., S.S.-T., E.S., D.N., J.M., H.H.).,Faculty of Medicine, Tel Aviv University, Israel. (E.B.A., O.T., A.D.K., S.S.-T., D.N., H.H.)
| | - Amos D Korczyn
- Faculty of Medicine, Tel Aviv University, Israel. (E.B.A., O.T., A.D.K., S.S.-T., D.N., H.H.)
| | - Zahava Solomon
- Bob Shapell School of Social Work, Tel Aviv University, Israel. (Z.S.)
| | - Natan M Bornstein
- Department of Neurology, Shaare Zedek Medical Center, Jerusalem, Israel (N.M.B.)
| | - Shani Shenhar-Tsarfaty
- Departments of Neurology, Psychiatry and Radiology, Tel Aviv Sourasky Medical Center, Israel (E.B.A., O.T., S.S.-T., E.S., D.N., J.M., H.H.).,Faculty of Medicine, Tel Aviv University, Israel. (E.B.A., O.T., A.D.K., S.S.-T., D.N., H.H.)
| | - Estelle Seyman
- Departments of Neurology, Psychiatry and Radiology, Tel Aviv Sourasky Medical Center, Israel (E.B.A., O.T., S.S.-T., E.S., D.N., J.M., H.H.)
| | - Dana Niry
- Departments of Neurology, Psychiatry and Radiology, Tel Aviv Sourasky Medical Center, Israel (E.B.A., O.T., S.S.-T., E.S., D.N., J.M., H.H.).,Faculty of Medicine, Tel Aviv University, Israel. (E.B.A., O.T., A.D.K., S.S.-T., D.N., H.H.)
| | - Jeremy Molad
- Departments of Neurology, Psychiatry and Radiology, Tel Aviv Sourasky Medical Center, Israel (E.B.A., O.T., S.S.-T., E.S., D.N., J.M., H.H.)
| | - Hen Hallevi
- Departments of Neurology, Psychiatry and Radiology, Tel Aviv Sourasky Medical Center, Israel (E.B.A., O.T., S.S.-T., E.S., D.N., J.M., H.H.).,Faculty of Medicine, Tel Aviv University, Israel. (E.B.A., O.T., A.D.K., S.S.-T., D.N., H.H.)
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Naharci MI, Veizi BGY, Katipoglu B, Tasci I. Psychological Burden among Community-dwelling Older Adults with and without a History of a Recent Covid-19 Infection. Clin Gerontol 2022; 45:120-129. [PMID: 34053413 DOI: 10.1080/07317115.2021.1928358] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
OBJECTIVES The outbreak of Covid-19's psychological burden to recovered vs. non-infected older individuals has not been compared yet. We aimed to perform a comparative analysis of psychological symptoms in community-dwelling older adults with and without a history of a Covid-19 infection. METHODS In this study, we utilized a geriatric care unit's outpatient registry to prospectively enroll older adults with and without a history of Covid-19. An interviewer administered generalized anxiety disorder-2 (GAD-2), patient health questionnaire-2 (PHQ-2), six-item cognitive impairment (6-CIT), and post-traumatic stress disorder-5 (PTSD-5) tests over the phone. Correlation and multivariate logistic regression analyses were used to examine associations. RESULTS The study included 120 older subjects, 46 (38.3%) reported past Covid-19 infection. Anxiety and depression were both significantly more prevalent among subjects without a history of Covid-19. Having no history of Covid-19, female gender, and psychoactive medication use showed independent associations with the risk of depression symptoms among all subjects, and female gender was additionally associated with anxiety symptoms. CONCLUSIONS This study showed that the risk of depression symptoms was higher in a sample of older adults who were not infected with Covid-19 compared to those recovering from the disease. CLINICAL IMPLICATIONS The impact of "fear of transmission" on the mental health of the elderly may be a significant issue to deal with. Older women are more prone to mental health risks by Covid-19.
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Affiliation(s)
- Mehmet Ilkin Naharci
- Gulhane Faculty of Medicine & Gulhane Training and Research Hospital, Division of Geriatrics, University of Health Sciences, Ankara, Turkey
| | - Betul Gulsum Yavuz Veizi
- Gulhane Faculty of Medicine & Gulhane Training and Research Hospital, Division of Geriatrics, University of Health Sciences, Ankara, Turkey
| | - Bilal Katipoglu
- Gulhane Faculty of Medicine & Gulhane Training and Research Hospital, Division of Geriatrics, University of Health Sciences, Ankara, Turkey
| | - Ilker Tasci
- Gulhane Faculty of Medicine & Gulhane Training and Research Hospital, Department of Internal Medicine, University of Health Sciences, Ankara, Turkey
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Ben-Ari A, Aloni R, Ben-David S, Benarroch F, Margalit D. Parental Psychological Flexibility as a Mediating Factor of Post-Traumatic Stress Disorder in Children after Hospitalization or Surgery. Int J Environ Res Public Health 2021; 18:11699. [PMID: 34770210 PMCID: PMC8582780 DOI: 10.3390/ijerph182111699] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Revised: 10/31/2021] [Accepted: 11/02/2021] [Indexed: 11/16/2022]
Abstract
BACKGROUND Illness, surgery, and surgical hospitalization are significant stressors for children. Children exposed to such medical events may develop post-traumatic medical syndrome (PMTS, pediatric medical traumatic stress) that could slow their physical and emotional recovery. OBJECTIVE This study examined the relationship between the level of parental psychological resilience and the development of PMTS in young children. METHOD We surveyed 152 parents of children aged 1-6 who were admitted to the pediatric surgery department. Parents completed questionnaires in two phases. In the first phase, one of the parents completed the Acceptance and Action Questionnaire (AAQ-ll) and the Parental Psychological Flexibility (PPF) Questionnaire. In the second phase, about three months after discharge, the same parent completed the Young Child PTSD (Post Traumatic Stress Disorder) Checklist (YCPC) and the UCLA (Los Angeles, CA, USA) PTSD Reaction Index for DSM-5 Parent/Caregiver Version for Children Age 6 Years and Younger Evaluating Post-traumatic Disorder. In addition, the parent completed a Posttraumatic Stress Diagnostic Scale (PDS) questionnaire to assess the existence of post-traumatic symptoms in the parents. RESULTS The findings indicate that (1) a parent's psychological flexibility is significantly associated with the level of personal distress (r = -0.45, p < 0.001), (2) a parents' level of distress is significantly correlated with the child's level of PTMS, and (3) a parent's level of psychological flexibility is a significant mediating factor between the level of parental post-traumatic distress and the child's level of PTMS. CONCLUSIONS A parent's psychological flexibility may act as a protective factor against the development of the child's mental distress after hospitalization or surgery.
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Affiliation(s)
- Amichai Ben-Ari
- Department of Behavioral Sciences, Ariel University, Ben-Zakai 36/8, Jerusalem 9318659, Israel; (R.A.); (D.M.)
- Herman Dana Division of Child and Adolescent Psychiatry, Hadassah-Hebrew University Medical Center, Jerusalem 91240, Israel;
| | - Roy Aloni
- Department of Behavioral Sciences, Ariel University, Ben-Zakai 36/8, Jerusalem 9318659, Israel; (R.A.); (D.M.)
| | - Shiri Ben-David
- Department of Psychology, Hebrew University, Jerusalem 9190501, Israel;
- Hadassah Medical Center, Department of Psychiatry, Jerusalem 91120, Israel
| | - Fortu Benarroch
- Herman Dana Division of Child and Adolescent Psychiatry, Hadassah-Hebrew University Medical Center, Jerusalem 91240, Israel;
| | - Daniella Margalit
- Department of Behavioral Sciences, Ariel University, Ben-Zakai 36/8, Jerusalem 9318659, Israel; (R.A.); (D.M.)
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21
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Rigutto C, Sapara AO, Agyapong VIO. Anxiety, Depression and Posttraumatic Stress Disorder after Terrorist Attacks: A General Review of the Literature. Behav Sci (Basel) 2021; 11:bs11100140. [PMID: 34677233 PMCID: PMC8533613 DOI: 10.3390/bs11100140] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2021] [Revised: 09/22/2021] [Accepted: 09/27/2021] [Indexed: 12/13/2022] Open
Abstract
Terrorism, though not well-defined, is a violent act that has been shown to have longstanding effects on the mental health of those who witness it. The aim of this general literature review is to explore the effect that terrorism has on posttraumatic stress disorder (PTSD), major depressive disorder (MDD) and anxiety disorders, as well as the bio-psycho-social determinants that mediate its impact. This paper describes the prevalence, risk factors, protective factors, common presentations and interventions identified for PTSD, depression and anxiety disorders occurring following terrorist attacks. We conducted a literature search in MEDLINE using a number of keywords detailed below. After applying inclusion and exclusion criteria, we kept 80 articles, which we summarized in tabular form. A majority of articles found detailed the impact of terrorism on PTSD, and took place in a Western, mainly American setting. The main factors that impacted the presentation of mental illness include gender, ethnicity, social supports, socioeconomic status, level of preparedness, level of exposure, pre-existing trauma and mental illness, and subsequent life stressors. The main intervention detailed in this article as showing evidence post-terrorism is trauma-focused cognitive-behavioural therapy. This study highlights the importance of this topic, and in particular, its implications for public health policy and practice.
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22
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Alshehri AS, Alghamdi AH. Post-traumatic Stress Disorder Among Healthcare Workers Diagnosed With COVID-19 in Jeddah, Kingdom of Saudi Arabia, 2020 to 2021. Cureus 2021; 13:e17371. [PMID: 34584781 PMCID: PMC8457300 DOI: 10.7759/cureus.17371] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/22/2021] [Indexed: 12/23/2022] Open
Abstract
Background Post-traumatic stress disorder (PTSD) is a global problem. According to its definition, it is a disorder that occurs with some people who have undergone or witnessed a shocking, terrifying, or hazardous event, and the coronavirus disease (COVID-19) with its consequent threats and fear meets the definition of a traumatic event. The main aim of this study is to determine PTSD in healthcare workers (HCWs) who survived COVID-19 in Jeddah, Saudi Arabia. Subjects and methods Through an analytical cross-sectional study, HCWs working in Jeddah city with a minimum of seven days since their first positive COVID-19 result were included in this study. They were screened using the 'PTSD checklist for The Diagnostic and Statistical Manual of Mental Disorders (DSM-5)' (PCL-5), which is a 20-item self-report measure that assesses the presence and severity of PTSD symptoms. Results Out of all respondents (n=404), there was slight dominance of females (54.0%) over males (46.0%), and an almost equal distribution of Saudis (51.2%) and non-Saudis (48.8%); their mean age accounted for 36.9±8.7 years. PTSD was detected in 14.9%; the prevalence was significantly higher in those who had chronic diseases (23.7%), especially diabetics (30.8%) and obesity (41.2%), HCWs whose job necessitates exposure to positive cases (18.8%), and those who were isolated in hospitals while being ill. All the above values were statistically significant (p<0.05). Conclusion and recommendations The prevalence of PTSD in the HCWs who survived COVID-19 came within the range of that in HCWs who were dealing with cases of COVID-19 without being affected. Efforts should be made to alleviate stress in HCWs during their work in pandemics.
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Affiliation(s)
- Amjed S Alshehri
- Directorate of Health Affairs for Public Health Division, Ministry of Health - Kingdom of Saudi Arabia, Jeddah, SAU
| | - Amal H Alghamdi
- The Saudi Joint Program for Preventive Medicine, Ministry of Health - Kingdom of Saudi Arabia, Jeddah, SAU
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23
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El Ayoubi H, Brunault P, Barrault S, Maugé D, Baudin G, Ballon N, El-Hage W. Posttraumatic Stress Disorder Is Highly Comorbid With Adult ADHD in Alcohol Use Disorder Inpatients. J Atten Disord 2021; 25:1594-1602. [PMID: 32396413 DOI: 10.1177/1087054720903363] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Objective: Increasing number of studies show an association between adult ADHD (a-ADHD) and posttraumatic stress disorder (PTSD). We explored this association in alcohol use disorder (AUD) inpatients. Method: In total, 551 inpatients cross-sectionally completed self-administered questionnaires regarding sociodemographics, lifetime trauma exposure, PTSD Checklist for DSM-5, Adult ADHD Self-Report Scale (ASRS), and Wender Utah Rating Scale (WURS). We considered self-reported a-ADHD when ASRS and WURS had significant scores. Results: Prevalence for a-ADHD was 20%. PTSD prevalence was higher in a-ADHD patients (84% vs. 40%; p < .001). They also were younger (p < .001) and women (p = .015). Adult ADHD was associated with more traumatic events, and symptoms were correlated with PTSD severity. After adjusting for age, gender and marital status, PTSD severity was associated with a-ADHD. Conclusion: Our study confirms that a-ADHD is associated with PTSD in AUD inpatients, and thus, may represent a specific subpopulation. Future studies should explore implication of this dual diagnosis on AUD and treatment outcome.
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Affiliation(s)
- Hussein El Ayoubi
- CHRU de Tours, Équipe de Liaison et de Soins en Addictologie, Tours, France.,Centre Hospitalier Louis Sevestre, La Membrolle-sur-Choisille, Tours, France.,CHRU de Tours, CSAPA-37, Tours, France
| | - Paul Brunault
- CHRU de Tours, Équipe de Liaison et de Soins en Addictologie, Tours, France.,UMR 1253, iBrain, Université de Tours, Inserm, Tours, France.,Qualipsy EE 1901, Université de Tours, France
| | - Servane Barrault
- CHRU de Tours, CSAPA-37, Tours, France.,Qualipsy EE 1901, Université de Tours, France
| | | | - Grégoire Baudin
- Qualipsy EE 1901, Université de Tours, France.,Laboratory of Psychopathology and Health Processes EA 4057, University Paris Descartes, Sorbonne Paris Cité, Boulogne-Billancourt, France
| | - Nicolas Ballon
- CHRU de Tours, Équipe de Liaison et de Soins en Addictologie, Tours, France.,UMR 1253, iBrain, Université de Tours, Inserm, Tours, France
| | - Wissam El-Hage
- UMR 1253, iBrain, Université de Tours, Inserm, Tours, France.,CHRU de Tours, Clinique Psychiatrique Universitaire, Tours, France.,CHRU de Tours, Centre R�gional de Psychotraumatologie Centre Val de Loire, Tours, France
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Nehring I, Sattel H, Al-Hallak M, Sack M, Henningsen P, Mall V, Aberl S. The Child Behavior Checklist as a Screening Instrument for PTSD in Refugee Children. Children (Basel) 2021; 8:521. [PMID: 34207254 PMCID: PMC8235248 DOI: 10.3390/children8060521] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Revised: 06/15/2021] [Accepted: 06/16/2021] [Indexed: 12/30/2022]
Abstract
Thousands of refugees who have entered Europe experienced threatening conditions, potentially leading to post traumatic stress disorder (PTSD), which has to be detected and treated early to avoid chronic manifestation, especially in children. We aimed to evaluate and test suitable screening tools to detect PTSD in children. Syrian refugee children aged 4-14 years were examined using the PTSD-semi-structured interview, the Kinder-DIPS, and the Child Behavior Checklist (CBCL). The latter was evaluated as a potential screening tool for PTSD using (i) the CBCL-PTSD subscale and (ii) an alternative subscale consisting of a psychometrically guided selection of items with an appropriate correlation to PTSD and a sufficient prevalence (presence in more than 20% of the cases with PTSD). For both tools we calculated sensitivity, specificity, and a receiver operating characteristic (ROC) curve. Depending on the sum score of the items, the 20-item CBCL-PTSD subscale as used in previous studies yielded a maximal sensitivity of 85% and specificity of 76%. The psychometrically guided item selection resulted in a sensitivity of 85% and a specificity of 83%. The areas under the ROC curves were the same for both tools (0.9). Both subscales may be suitable as screening instrument for PTSD in refugee children, as they reveal a high sensitivity and specificity.
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Affiliation(s)
- Ina Nehring
- Department of Social Pediatrics, Technische Universität München, D-81377 Munich, Germany; (M.A.-H.); (V.M.)
| | - Heribert Sattel
- Department of Psychosomatic Medicine and Psychotherapy, Klinikum rechts der Isar, Technische Universität München, D-81377 Munich, Germany; (H.S.); (M.S.); (P.H.); (S.A.)
| | - Maesa Al-Hallak
- Department of Social Pediatrics, Technische Universität München, D-81377 Munich, Germany; (M.A.-H.); (V.M.)
| | - Martin Sack
- Department of Psychosomatic Medicine and Psychotherapy, Klinikum rechts der Isar, Technische Universität München, D-81377 Munich, Germany; (H.S.); (M.S.); (P.H.); (S.A.)
| | - Peter Henningsen
- Department of Psychosomatic Medicine and Psychotherapy, Klinikum rechts der Isar, Technische Universität München, D-81377 Munich, Germany; (H.S.); (M.S.); (P.H.); (S.A.)
| | - Volker Mall
- Department of Social Pediatrics, Technische Universität München, D-81377 Munich, Germany; (M.A.-H.); (V.M.)
| | - Sigrid Aberl
- Department of Psychosomatic Medicine and Psychotherapy, Klinikum rechts der Isar, Technische Universität München, D-81377 Munich, Germany; (H.S.); (M.S.); (P.H.); (S.A.)
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Latimer D, Stocker MD, Sayers K, Green J, Kaye AM, Abd-Elsayed A, Cornett EM, Kaye AD, Varrassi G, Viswanath O, Urits I. MDMA to Treat PTSD in Adults. Psychopharmacol Bull 2021; 51:125-149. [PMID: 34421149 PMCID: PMC8374929] [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] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Post-traumatic stress disorder (PTSD) has become one of the most common psychiatric diagnosis in the United States specifically within the veteran population. The current treatment options for this debilitating diagnosis include trauma-focused psychotherapies along with selective serotonin reuptake inhibitors (SSRI) and serotonin-norepinephrine reuptake inhibitors (SNRI).1 MDMA has recently been shown as a novel therapeutic agent with promisingly results in the treatment of PTSD. MDMA is a psychoactive compound traditionally categorized as a psychedelic amphetamine that deemed a Schedule I controlled substance in the 1980s. Prior to its status as a controlled substance, it was used by psychotherapists for an array of psychiatric issues. In more recent times, MDMA has resurfaced as a potential therapy for PTSD and the data produced from randomized, controlled trials back the desire for MDMA to be utilized as an effective pharmacologic therapy in conjunction with psychotherapy.2.
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Affiliation(s)
- Dustin Latimer
- Latimer, Louisiana State University Health Science Center, Department of Psychiatry and Behavioral Medicine in Baton Rouge. Michael D. Stocker, Kia Sayers, Louisiana State University New Orleans School of Medicine. Green, Visions Adolescent Treatment Center, Department of Mental Health, Los Angeles, CA. Adam M. Kaye, Thomas J. Long School of Pharmacy and Health Sciences, University of the Pacific, Department of Pharmacy Practice, Stockton, CA. Alaa Abd-Elsayed, University of Wisconsin School of Medicine and Public Health, Department of Anesthesiology, Madison, WI. Elyse M. Cornett, Alan D. Kaye, Louisiana State University Shreveport, Department of Anesthesiology, Shreveport, LA. Varrassi, Paolo Procacci Foundation, Via Tacito 7, Roma, Italy. Viswanath, Louisiana State University Shreveport, Department of Anesthesiology, Shreveport, LA; University of Arizona College of Medicine-Phoenix, Phoenix, AZ; Creighton University School of Medicine, Department of Anesthesiology, Omaha, NE; Valley Anesthesiology and Pain Consultants-Envision Physician Services, Phoenix, AZ. Ivan Urits, Louisiana State University Shreveport, Department of Anesthesiology, Shreveport, LA; Southcoast Health, Southcoast Health Physicians Group Pain Medicine, Wareham, MA
| | - Michael D Stocker
- Latimer, Louisiana State University Health Science Center, Department of Psychiatry and Behavioral Medicine in Baton Rouge. Michael D. Stocker, Kia Sayers, Louisiana State University New Orleans School of Medicine. Green, Visions Adolescent Treatment Center, Department of Mental Health, Los Angeles, CA. Adam M. Kaye, Thomas J. Long School of Pharmacy and Health Sciences, University of the Pacific, Department of Pharmacy Practice, Stockton, CA. Alaa Abd-Elsayed, University of Wisconsin School of Medicine and Public Health, Department of Anesthesiology, Madison, WI. Elyse M. Cornett, Alan D. Kaye, Louisiana State University Shreveport, Department of Anesthesiology, Shreveport, LA. Varrassi, Paolo Procacci Foundation, Via Tacito 7, Roma, Italy. Viswanath, Louisiana State University Shreveport, Department of Anesthesiology, Shreveport, LA; University of Arizona College of Medicine-Phoenix, Phoenix, AZ; Creighton University School of Medicine, Department of Anesthesiology, Omaha, NE; Valley Anesthesiology and Pain Consultants-Envision Physician Services, Phoenix, AZ. Ivan Urits, Louisiana State University Shreveport, Department of Anesthesiology, Shreveport, LA; Southcoast Health, Southcoast Health Physicians Group Pain Medicine, Wareham, MA
| | - Kia Sayers
- Latimer, Louisiana State University Health Science Center, Department of Psychiatry and Behavioral Medicine in Baton Rouge. Michael D. Stocker, Kia Sayers, Louisiana State University New Orleans School of Medicine. Green, Visions Adolescent Treatment Center, Department of Mental Health, Los Angeles, CA. Adam M. Kaye, Thomas J. Long School of Pharmacy and Health Sciences, University of the Pacific, Department of Pharmacy Practice, Stockton, CA. Alaa Abd-Elsayed, University of Wisconsin School of Medicine and Public Health, Department of Anesthesiology, Madison, WI. Elyse M. Cornett, Alan D. Kaye, Louisiana State University Shreveport, Department of Anesthesiology, Shreveport, LA. Varrassi, Paolo Procacci Foundation, Via Tacito 7, Roma, Italy. Viswanath, Louisiana State University Shreveport, Department of Anesthesiology, Shreveport, LA; University of Arizona College of Medicine-Phoenix, Phoenix, AZ; Creighton University School of Medicine, Department of Anesthesiology, Omaha, NE; Valley Anesthesiology and Pain Consultants-Envision Physician Services, Phoenix, AZ. Ivan Urits, Louisiana State University Shreveport, Department of Anesthesiology, Shreveport, LA; Southcoast Health, Southcoast Health Physicians Group Pain Medicine, Wareham, MA
| | - Jackson Green
- Latimer, Louisiana State University Health Science Center, Department of Psychiatry and Behavioral Medicine in Baton Rouge. Michael D. Stocker, Kia Sayers, Louisiana State University New Orleans School of Medicine. Green, Visions Adolescent Treatment Center, Department of Mental Health, Los Angeles, CA. Adam M. Kaye, Thomas J. Long School of Pharmacy and Health Sciences, University of the Pacific, Department of Pharmacy Practice, Stockton, CA. Alaa Abd-Elsayed, University of Wisconsin School of Medicine and Public Health, Department of Anesthesiology, Madison, WI. Elyse M. Cornett, Alan D. Kaye, Louisiana State University Shreveport, Department of Anesthesiology, Shreveport, LA. Varrassi, Paolo Procacci Foundation, Via Tacito 7, Roma, Italy. Viswanath, Louisiana State University Shreveport, Department of Anesthesiology, Shreveport, LA; University of Arizona College of Medicine-Phoenix, Phoenix, AZ; Creighton University School of Medicine, Department of Anesthesiology, Omaha, NE; Valley Anesthesiology and Pain Consultants-Envision Physician Services, Phoenix, AZ. Ivan Urits, Louisiana State University Shreveport, Department of Anesthesiology, Shreveport, LA; Southcoast Health, Southcoast Health Physicians Group Pain Medicine, Wareham, MA
| | - Adam M Kaye
- Latimer, Louisiana State University Health Science Center, Department of Psychiatry and Behavioral Medicine in Baton Rouge. Michael D. Stocker, Kia Sayers, Louisiana State University New Orleans School of Medicine. Green, Visions Adolescent Treatment Center, Department of Mental Health, Los Angeles, CA. Adam M. Kaye, Thomas J. Long School of Pharmacy and Health Sciences, University of the Pacific, Department of Pharmacy Practice, Stockton, CA. Alaa Abd-Elsayed, University of Wisconsin School of Medicine and Public Health, Department of Anesthesiology, Madison, WI. Elyse M. Cornett, Alan D. Kaye, Louisiana State University Shreveport, Department of Anesthesiology, Shreveport, LA. Varrassi, Paolo Procacci Foundation, Via Tacito 7, Roma, Italy. Viswanath, Louisiana State University Shreveport, Department of Anesthesiology, Shreveport, LA; University of Arizona College of Medicine-Phoenix, Phoenix, AZ; Creighton University School of Medicine, Department of Anesthesiology, Omaha, NE; Valley Anesthesiology and Pain Consultants-Envision Physician Services, Phoenix, AZ. Ivan Urits, Louisiana State University Shreveport, Department of Anesthesiology, Shreveport, LA; Southcoast Health, Southcoast Health Physicians Group Pain Medicine, Wareham, MA
| | - Alaa Abd-Elsayed
- Latimer, Louisiana State University Health Science Center, Department of Psychiatry and Behavioral Medicine in Baton Rouge. Michael D. Stocker, Kia Sayers, Louisiana State University New Orleans School of Medicine. Green, Visions Adolescent Treatment Center, Department of Mental Health, Los Angeles, CA. Adam M. Kaye, Thomas J. Long School of Pharmacy and Health Sciences, University of the Pacific, Department of Pharmacy Practice, Stockton, CA. Alaa Abd-Elsayed, University of Wisconsin School of Medicine and Public Health, Department of Anesthesiology, Madison, WI. Elyse M. Cornett, Alan D. Kaye, Louisiana State University Shreveport, Department of Anesthesiology, Shreveport, LA. Varrassi, Paolo Procacci Foundation, Via Tacito 7, Roma, Italy. Viswanath, Louisiana State University Shreveport, Department of Anesthesiology, Shreveport, LA; University of Arizona College of Medicine-Phoenix, Phoenix, AZ; Creighton University School of Medicine, Department of Anesthesiology, Omaha, NE; Valley Anesthesiology and Pain Consultants-Envision Physician Services, Phoenix, AZ. Ivan Urits, Louisiana State University Shreveport, Department of Anesthesiology, Shreveport, LA; Southcoast Health, Southcoast Health Physicians Group Pain Medicine, Wareham, MA
| | - Elyse M Cornett
- Latimer, Louisiana State University Health Science Center, Department of Psychiatry and Behavioral Medicine in Baton Rouge. Michael D. Stocker, Kia Sayers, Louisiana State University New Orleans School of Medicine. Green, Visions Adolescent Treatment Center, Department of Mental Health, Los Angeles, CA. Adam M. Kaye, Thomas J. Long School of Pharmacy and Health Sciences, University of the Pacific, Department of Pharmacy Practice, Stockton, CA. Alaa Abd-Elsayed, University of Wisconsin School of Medicine and Public Health, Department of Anesthesiology, Madison, WI. Elyse M. Cornett, Alan D. Kaye, Louisiana State University Shreveport, Department of Anesthesiology, Shreveport, LA. Varrassi, Paolo Procacci Foundation, Via Tacito 7, Roma, Italy. Viswanath, Louisiana State University Shreveport, Department of Anesthesiology, Shreveport, LA; University of Arizona College of Medicine-Phoenix, Phoenix, AZ; Creighton University School of Medicine, Department of Anesthesiology, Omaha, NE; Valley Anesthesiology and Pain Consultants-Envision Physician Services, Phoenix, AZ. Ivan Urits, Louisiana State University Shreveport, Department of Anesthesiology, Shreveport, LA; Southcoast Health, Southcoast Health Physicians Group Pain Medicine, Wareham, MA
| | - Alan D Kaye
- Latimer, Louisiana State University Health Science Center, Department of Psychiatry and Behavioral Medicine in Baton Rouge. Michael D. Stocker, Kia Sayers, Louisiana State University New Orleans School of Medicine. Green, Visions Adolescent Treatment Center, Department of Mental Health, Los Angeles, CA. Adam M. Kaye, Thomas J. Long School of Pharmacy and Health Sciences, University of the Pacific, Department of Pharmacy Practice, Stockton, CA. Alaa Abd-Elsayed, University of Wisconsin School of Medicine and Public Health, Department of Anesthesiology, Madison, WI. Elyse M. Cornett, Alan D. Kaye, Louisiana State University Shreveport, Department of Anesthesiology, Shreveport, LA. Varrassi, Paolo Procacci Foundation, Via Tacito 7, Roma, Italy. Viswanath, Louisiana State University Shreveport, Department of Anesthesiology, Shreveport, LA; University of Arizona College of Medicine-Phoenix, Phoenix, AZ; Creighton University School of Medicine, Department of Anesthesiology, Omaha, NE; Valley Anesthesiology and Pain Consultants-Envision Physician Services, Phoenix, AZ. Ivan Urits, Louisiana State University Shreveport, Department of Anesthesiology, Shreveport, LA; Southcoast Health, Southcoast Health Physicians Group Pain Medicine, Wareham, MA
| | - Giustino Varrassi
- Latimer, Louisiana State University Health Science Center, Department of Psychiatry and Behavioral Medicine in Baton Rouge. Michael D. Stocker, Kia Sayers, Louisiana State University New Orleans School of Medicine. Green, Visions Adolescent Treatment Center, Department of Mental Health, Los Angeles, CA. Adam M. Kaye, Thomas J. Long School of Pharmacy and Health Sciences, University of the Pacific, Department of Pharmacy Practice, Stockton, CA. Alaa Abd-Elsayed, University of Wisconsin School of Medicine and Public Health, Department of Anesthesiology, Madison, WI. Elyse M. Cornett, Alan D. Kaye, Louisiana State University Shreveport, Department of Anesthesiology, Shreveport, LA. Varrassi, Paolo Procacci Foundation, Via Tacito 7, Roma, Italy. Viswanath, Louisiana State University Shreveport, Department of Anesthesiology, Shreveport, LA; University of Arizona College of Medicine-Phoenix, Phoenix, AZ; Creighton University School of Medicine, Department of Anesthesiology, Omaha, NE; Valley Anesthesiology and Pain Consultants-Envision Physician Services, Phoenix, AZ. Ivan Urits, Louisiana State University Shreveport, Department of Anesthesiology, Shreveport, LA; Southcoast Health, Southcoast Health Physicians Group Pain Medicine, Wareham, MA
| | - Omar Viswanath
- Latimer, Louisiana State University Health Science Center, Department of Psychiatry and Behavioral Medicine in Baton Rouge. Michael D. Stocker, Kia Sayers, Louisiana State University New Orleans School of Medicine. Green, Visions Adolescent Treatment Center, Department of Mental Health, Los Angeles, CA. Adam M. Kaye, Thomas J. Long School of Pharmacy and Health Sciences, University of the Pacific, Department of Pharmacy Practice, Stockton, CA. Alaa Abd-Elsayed, University of Wisconsin School of Medicine and Public Health, Department of Anesthesiology, Madison, WI. Elyse M. Cornett, Alan D. Kaye, Louisiana State University Shreveport, Department of Anesthesiology, Shreveport, LA. Varrassi, Paolo Procacci Foundation, Via Tacito 7, Roma, Italy. Viswanath, Louisiana State University Shreveport, Department of Anesthesiology, Shreveport, LA; University of Arizona College of Medicine-Phoenix, Phoenix, AZ; Creighton University School of Medicine, Department of Anesthesiology, Omaha, NE; Valley Anesthesiology and Pain Consultants-Envision Physician Services, Phoenix, AZ. Ivan Urits, Louisiana State University Shreveport, Department of Anesthesiology, Shreveport, LA; Southcoast Health, Southcoast Health Physicians Group Pain Medicine, Wareham, MA
| | - Ivan Urits
- Latimer, Louisiana State University Health Science Center, Department of Psychiatry and Behavioral Medicine in Baton Rouge. Michael D. Stocker, Kia Sayers, Louisiana State University New Orleans School of Medicine. Green, Visions Adolescent Treatment Center, Department of Mental Health, Los Angeles, CA. Adam M. Kaye, Thomas J. Long School of Pharmacy and Health Sciences, University of the Pacific, Department of Pharmacy Practice, Stockton, CA. Alaa Abd-Elsayed, University of Wisconsin School of Medicine and Public Health, Department of Anesthesiology, Madison, WI. Elyse M. Cornett, Alan D. Kaye, Louisiana State University Shreveport, Department of Anesthesiology, Shreveport, LA. Varrassi, Paolo Procacci Foundation, Via Tacito 7, Roma, Italy. Viswanath, Louisiana State University Shreveport, Department of Anesthesiology, Shreveport, LA; University of Arizona College of Medicine-Phoenix, Phoenix, AZ; Creighton University School of Medicine, Department of Anesthesiology, Omaha, NE; Valley Anesthesiology and Pain Consultants-Envision Physician Services, Phoenix, AZ. Ivan Urits, Louisiana State University Shreveport, Department of Anesthesiology, Shreveport, LA; Southcoast Health, Southcoast Health Physicians Group Pain Medicine, Wareham, MA
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Nabors C, Frishman WH, Dhand A, Yandrapalli S, Kumar A, Pratt M, Halperin EC. The Impact on Medical Students of the 9/11 Attacks on New York's World Trade Center. Teach Learn Med 2021; 33:129-138. [PMID: 33074731 DOI: 10.1080/10401334.2020.1818566] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Phenomenon: Little is known about how participation in disaster relief impacts medical students. During the terror attacks of September 11, 2001, New York Medical College School of Medicine students witnessed the attacks and then became members of emergency treatment teams at St. Vincent's Hospital, the trauma center nearest to the World Trade Center. To date, only two reports describe how 9/11 influenced the lives of medical students. This study was designed to characterize the short- and long-term effects on NYMC students and to compare those effects between students assigned to St Vincent's Hospital and classmates assigned to rotations at facilities more remote from the attack site. We hypothesized that participation in direct relief efforts by students assigned to the St. Vincent's site might have long-lasting effects on their lives and these effects might vary when compared to classmates assigned elsewhere. Approach: This was a retrospective, survey-based, unmatched cohort study. Participants included all school of medicine graduates who were St. Vincent's rotators on 9/11 (N = 22) and classmates (N = 24) assigned to other sites who could be contacted and agreed to participate. Our primary measure was whether the 9/11 experience affected the participant's life, defined as an affirmative response to the item which asked whether the 9/11 experience affected the participant's "life thereafter, career choice, attitudes toward life or attitudes toward practice." Secondary measures included self-reported effects on career, life, attitudes, health, resilience, personal growth, personality features, and the temporal relationship between the attack and stress symptoms. Findings: Completed surveys were received from 16/22 (73%) St. Vincent's and 18/24 (75%) non-Saint Vincent's participants: 62% male, 82% had children, 74% identified as Caucasian/white and 76% employed full-time. Overall, slightly more than half (58%) of respondents reported an effect of 9/11 on their life, with a greater but non-significant proportion of St. Vincent's rotators reporting life impact (67% versus 50% for St. Vincent's versus other locations, respectively). High post-9/11 stress levels, current marriage, and ability to make and keep family and social relationships were associated with an effect on life which approached statistical significance. Participants reported positive or no post 9/11 effects on empathy and altruism (50%), resilience (47%), attitudes toward medical practice and career (32%), and charitable giving (24%), while positive, negative, or no effects were reported for attitude toward life, family and social relations, physical health, and conscientiousness. Mental health was the only domain in which all participants reported unchanged or negative effects. Two St. Vincent's rotators but no students assigned elsewhere believed they experienced 9/11-related post-traumatic stress disorder. Insights: Just over half of New York Medical College School of Medicine students rotating at St. Vincent's Hospital on 9/11 or elsewhere reported significant life-effects as a result of direct/indirect experiences related to the attack. Perceived stress may have been a more important driver of this life-change than other factors such as geographic proximity to the disaster site and/or direct participation in relief efforts. Further study of medical school interventions focused on stress reduction among students who participate in disaster relief is warranted.
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Affiliation(s)
- Christopher Nabors
- Department of Medicine, Westchester Medical Center and New York Medical College, Valhalla, New York, USA
| | - William H Frishman
- Department of Medicine, Westchester Medical Center and New York Medical College, Valhalla, New York, USA
| | - Abhay Dhand
- Department of Medicine, Division of Infectious Disease, Westchester Medical Center and New York Medical College, Valhalla, New York, USA
| | - Srikanth Yandrapalli
- Department of Medicine, Division of Cardiology, Westchester Medical Center and New York Medical College, Valhalla, New York, USA
| | - Anila Kumar
- Department of Medicine, Westchester Medical Center and New York Medical College, Valhalla, New York, USA
| | - Maryanne Pratt
- Department of Medicine, Westchester Medical Center and New York Medical College, Valhalla, New York, USA
| | - Edward C Halperin
- New York Medical College (NYMC) and Biomedical Affairs, Touro College and University System, New York, New York, USA
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Slade PP, Molyneux DR, Watt DA. A systematic review of clinical effectiveness of psychological interventions to reduce post traumatic stress symptoms following childbirth and a meta-synthesis of facilitators and barriers to uptake of psychological care. J Affect Disord 2021; 281:678-694. [PMID: 33220947 DOI: 10.1016/j.jad.2020.11.092] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2020] [Revised: 11/02/2020] [Accepted: 11/08/2020] [Indexed: 01/30/2023]
Abstract
AIM To review the literature on psychological interventions for post-traumatic stress following childbirth (PTSDFC) and determine clinical effectiveness. To synthesise the qualitative literature on the facilitators and barriers to uptake of care for PTSDFC. BACKGROUND The context of childbirth trauma differs from that of other events perceived as traumatic. Current guidance on treatment for PTSDFC requires further clarification. METHOD Web of Knowledge, CINAHL, MEDLINE, PSYCINFO, the Cochrane Central Register of Controlled Trials (CENTRAL), Open Grey, UKCTG, and the ISRCTN were consulted to include journal articles published in English.. Articles were segregated according to methodology and appraised using the Mixed Methods Appraisal Tool. RESULTS A total of 5355 papers were identified with five quantitative and 13 qualitative included in the review. Four types of interventions were identified: eye movement desensitisation and reprocessing, trauma focussed CBT, debriefing and expressive writing. All showed some effectiveness in treating PTSDFC. Themes emerging from the meta-synthesis included women finding it difficult to recognise having a problem, needing validation and only seeking help 'at breaking point'. Women wanted health professionals actively asking in a non-judgemental way at different time points and providing support and listening, ideally with continuity of carer to make sense of their experiences. LIMITATIONS Quantitative studies were not disaggregated by intervention timing or follow-up duration. A single independent reviewer with team discussion was utilised. CONCLUSION There is little definitive evidence assessing the effectiveness of psychological interventions for PTSDFC. There are psychological barriers for women accessing help for traumatic childbirth which services can mitigate.
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Affiliation(s)
| | - Dr Rebecca Molyneux
- Faculty of Health and Life Sciences, University of Liverpool, United Kingdom
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Abstract
BACKGROUND Sexual assault (SA) is highly prevalent in Belgium. In order to mitigate the negative consequences for victims of acute SA, Sexual Assault Care Centres (SACCs) were piloted from October 2017 to October 2018 in three Belgian hospitals. SACCs offer medical and psychological care, forensic examination and the possibility to report to the police at the SACC. OBJECTIVE Aiming to improve SACC services, we quantitatively assessed the number and characteristics of victims attending the SACC, the SA they experienced, and the care they received over 12 months upon admission. METHOD Data on victims presenting at the SACC were routinely collected in electronic patient files by the SACC personnel between 25 October 2017 and 31 October 2019. These data were analysed in IBM SPSS Statistics 25. RESULTS Within the first year 931 victims attended the SACCs. Mean age was 24.5 years (SD = 12.8), and one-third were under 18. The majority were female (90.5%) and 63.1% presented for rape. About one-third of the victims were considered vulnerable due to previous SA (35.6%), prior psychiatric consultation (38.7%) or disability (8.5%). The assailant was known to the victim in 59.2% of the cases. Of all SACC presentations, 35.2% self-referred to the SACC while 40.9% were referred by the police. Two out of three victims attended the SACC within 72 h post-assault. Respectively 74.7% of victims received medical care, 60.6% a forensic examination, 50.2% psychological care, and 68.7% reported to the police. CONCLUSION Despite the absence of promotion campaigns, the SACCs received a high number of victims during the pilot year. Use of acute and follow-up services was high, although new approaches to offer more accessible psychological support should be explored. The big proportion of vulnerable victims warrants careful monitoring and adaptation of care pathways.
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Affiliation(s)
- Saar Baert
- Department of Public Health and Primary Care, International Centre for Reproductive Health, Ghent University, Ghent, Belgium
| | - Christine Gilles
- Department of Obstetrics and Gynecology, Saint-Pierre University Hospital Brussels, Brussels, Belgium
| | - Sara Van Belle
- Department of Public Health, Institute of Tropical Medicine Antwerp, Antwerp, Belgium
| | - Iva Bicanic
- National Psychotrauma Center for Children and Youth, University Medical Center, Utrecht, The Netherlands
| | - Kristien Roelens
- Department of Human Structure and Repair, Ghent University Hospital, Ghent University, Ghent, Belgium
| | - Ines Keygnaert
- Department of Public Health and Primary Care, International Centre for Reproductive Health, Ghent University, Ghent, Belgium
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Gobbi S, Płomecka MB, Ashraf Z, Radziński P, Neckels R, Lazzeri S, Dedić A, Bakalović A, Hrustić L, Skórko B, Es haghi S, Almazidou K, Rodríguez-Pino L, Alp AB, Jabeen H, Waller V, Shibli D, Behnam MA, Arshad AH, Barańczuk-Turska Z, Haq Z, Qureshi SU, Jawaid A. Worsening of Preexisting Psychiatric Conditions During the COVID-19 Pandemic. Front Psychiatry 2020; 11:581426. [PMID: 33391049 PMCID: PMC7772353 DOI: 10.3389/fpsyt.2020.581426] [Citation(s) in RCA: 59] [Impact Index Per Article: 14.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2020] [Accepted: 11/13/2020] [Indexed: 02/02/2023] Open
Abstract
Objectives: To ascertain factors associated with worsening of psychiatric conditions during the coronavirus disease 2019 (COVID-19) pandemic. Methods: This study anonymously examined 2,734 psychiatric patients worldwide for worsening of their preexisting psychiatric conditions during the COVID-19 pandemic. An independent clinical investigation of 318 psychiatric patients from United States was used for verification. Results: Valid responses mainly from 12 featured countries indicated self-reported worsening of psychiatric conditions in two-thirds of the patients assessed that was through their significantly higher scores on scales for general psychological disturbance, posttraumatic stress disorder, and depression. Female gender, feeling no control of the situation, reporting dissatisfaction with the response of the state during the COVID-19 pandemic, and reduced interaction with family and friends increased the worsening of preexisting psychiatric conditions, whereas optimism, ability to share concerns with family and friends, and using social media like usual were associated with less worsening. An independent clinical investigation from the United States confirmed worsening of psychiatric conditions during the COVID-19 pandemic based on identification of new symptoms that necessitated clinical interventions such as dose adjustment or starting new medications in more than half of the patients. Conclusions: More than half of the patients are experiencing worsening of their psychiatric conditions during the COVID-19 pandemic.
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Affiliation(s)
- Susanna Gobbi
- Zurich Center for Neuroeconomics, University of Zurich, Zurich, Switzerland
| | - Martyna Beata Płomecka
- Methods of Plasticity Research, Department of Psychology, University of Zurich, Zurich, Switzerland
| | - Zainab Ashraf
- Faculty of Arts, University of Waterloo, Waterloo, ON, Canada
| | - Piotr Radziński
- Faculty of Mathematics, Informatics and Mechanics, University of Warsaw, Warsaw, Poland
| | - Rachael Neckels
- Biomolecular Sciences Graduate Program, Department of Biomolecular Sciences, Boise State University, Boise, ID, United States
| | - Samuel Lazzeri
- Faculty of Science and Engineering, University of Groningen, Groningen, Netherlands
| | - Alisa Dedić
- Faculty of Medicine, University of Tuzla, Tuzla, Bosnia and Herzegovina
| | - Asja Bakalović
- Faculty of Medicine, University of Tuzla, Tuzla, Bosnia and Herzegovina
| | - Lejla Hrustić
- Faculty of Medicine, University of Tuzla, Tuzla, Bosnia and Herzegovina
| | - Beata Skórko
- Faculty of Medicine, Medical University of Warsaw, Warsaw, Poland
| | - Sarvin Es haghi
- Faculty of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Kristina Almazidou
- Faculty of Veterinary Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | | | - A. Beyza Alp
- Faculty of Medicine, Maltepe University, Istanbul, Turkey
| | - Hafsa Jabeen
- Medical College, Dow University of Health Sciences, Karachi, Pakistan
| | - Verena Waller
- Department of Radiation Oncology, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Dana Shibli
- Faculty of Medicine, University of Jordan, Amman, Jordan
| | - Mehdi A. Behnam
- Neuroscience Center Zurich, University of Zurich/Swiss Federal Institute of Technology (ETH), Zurich, Switzerland
| | | | | | - Zeeshan Haq
- Texas Behavioral Health, Houston, TX, United States
| | | | - Ali Jawaid
- BRAINCITY Center of Excellence for Neural Plasticity and Brain Disorders, Nencki Institute of Experimental Biology, Warsaw, Poland
- Department of Neurology, University of Texas Health Science Center, Houston, TX, United States
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Abstract
While many studies have looked into the consequences of climate change on physical health, its impact on mental health is still relatively unknown. Climate-related disasters lead to psychotrauma in populations, as well as sleeping disorders, anxiety and depression. Rising temperatures increase the level of agression and violence. Climate migration also leads to psychological disorders in migrants. Mental health professionals must be trained in these pathologies which are set to become more common over the decades to come.
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Affiliation(s)
- Guillaume Fond
- Assistance publique-Hôpitaux de Marseille (AP-HM) Marseille Université, faculté de médecine - secteur Timone, EA 3279 : CEReSS - Centre d'étude et de recherche sur les services de santé et la qualité de vie, Hôpital La Conception, Marseille, France.
| | - Christophe Lançon
- Assistance publique-Hôpitaux de Marseille (AP-HM) Marseille Université, faculté de médecine - secteur Timone, EA 3279 : CEReSS - Centre d'étude et de recherche sur les services de santé et la qualité de vie, Hôpital La Conception, Marseille, France
| | - Pascal Auquier
- Assistance publique-Hôpitaux de Marseille (AP-HM) Marseille Université, faculté de médecine - secteur Timone, EA 3279 : CEReSS - Centre d'étude et de recherche sur les services de santé et la qualité de vie, Hôpital La Conception, Marseille, France
| | - Laurent Boyer
- Assistance publique-Hôpitaux de Marseille (AP-HM) Marseille Université, faculté de médecine - secteur Timone, EA 3279 : CEReSS - Centre d'étude et de recherche sur les services de santé et la qualité de vie, Hôpital La Conception, Marseille, France
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Syed S, Ashwick R, Schlosser M, Jones R, Rowe S, Billings J. Global prevalence and risk factors for mental health problems in police personnel: a systematic review and meta-analysis. Occup Environ Med 2020; 77:737-747. [PMID: 32439827 DOI: 10.1136/oemed-2020-106498] [Citation(s) in RCA: 48] [Impact Index Per Article: 12.0] [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: 02/21/2020] [Revised: 04/08/2020] [Accepted: 04/21/2020] [Indexed: 02/06/2023]
Abstract
Police face an increased risk of developing mental health problems, yet reliable estimates of their psychological difficulties remain unknown. This systematic review and meta-analysis estimate the pooled prevalence and risk factors for mental health problems among police personnel worldwide. Three independent reviewers searched 16 databases and screened 11 506 articles published between January 1980 and October 2019. Eligible studies involved at least 100 active police professionals and used validated instruments to ascertain specific mental health problems. Estimates were pooled using random-effects meta-analyses. In total, 60 cross-sectional and seven longitudinal studies, involving 272 463 police personnel from 24 countries met criteria for inclusion. The overall pooled point prevalence was 14.6% for depression (95% CI 10.9% to 18.6%), 14.2% for post-traumatic stress disorder (PTSD; 95% CI 10.3% to 18.7%), 9.6% for a generalised anxiety disorder (95% CI 6.7% to 12.9%), 8.5% for suicidal ideation (95% CI 6.1% to 11.2%), 5.0% for alcohol dependence (95% CI 3.5% to 6.7%) and 25.7% for hazardous drinking (95% CI 19.6% to 32.4%). The strongest risk factor for depression and suicidal ideation was higher occupational stress, and the strongest risk factors for PTSD were higher occupational stress and avoidant coping strategies. Higher levels of peer-support were associated with significantly lower PTSD symptoms. Our findings suggest that the prevalence of mental health problems among police exceeds twice that previously reported in mixed samples of first responders, and is associated with poor social support, occupational stress and maladaptive coping strategies. Without effective intervention, psychological difficulties will remain a substantial health concern among police.
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Affiliation(s)
- Shabeer Syed
- Oxford Institute of Clinical Psychology Training and Research, University of Oxford & Oxford Health NHS Foundation Trust, Oxford, UK .,Division of Psychiatry, University College London, London, UK
| | - Rachel Ashwick
- Oxford Institute of Clinical Psychology Training and Research, University of Oxford & Oxford Health NHS Foundation Trust, Oxford, UK
| | - Marco Schlosser
- Division of Psychiatry, University College London, London, UK
| | - Rebecca Jones
- Division of Psychiatry, University College London, London, UK
| | - Sarah Rowe
- Division of Psychiatry, University College London, London, UK
| | - Jo Billings
- Division of Psychiatry, University College London, London, UK
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Merino JJ, Muñetón-Gomez V, Muñetón-Gómez C, Pérez-Izquierdo MÁ, Loscertales M, Toledano Gasca A. Hippocampal CCR5/RANTES Elevations in a Rodent Model of Post-Traumatic Stress Disorder: Maraviroc (a CCR5 Antagonist) Increases Corticosterone Levels and Enhances Fear Memory Consolidation. Biomolecules 2020; 10:E212. [PMID: 32024104 PMCID: PMC7072246 DOI: 10.3390/biom10020212] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2019] [Revised: 01/26/2020] [Accepted: 01/27/2020] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND Contextual fear conditioning (CFC) is a rodent model that induces a high and long-lasting level of conditioning associated with traumatic memory formation; this behavioral paradigm resembles many characteristics of posttraumatic stress disorder (PSTD). Chemokines (chemotactic cytokines) play a known role in neuronal migration and neurodegeneration but their role in cognition is not totally elucidated. AIM We ascertain whether CCR5/RANTES beta chemokines (hippocampus/prefrontal cortex) could play a role in fear memory consolidation (CFC paradigm). We also evaluated whether chronic stress restraint (21 days of restraint, 6-h/day) could regulate levels of these beta chemokines in CFC-trained rats; fear memory retention was determined taking the level of freezing (context and tone) by the animals as an index of fear memory consolidation 24 h after CFC training session; these chemokines (CCR5/RANTES) and IL-6 levels were measured in the hippocampus and prefrontal cortex of chronically stressed rats, 24 h after CFC post-training, and compared with undisturbed CFC-trained rats (Experiment 1). In Experiment 2, rats received 1 mA of footshock during the CFC training session and fear memory consolidation was evaluated at 12 and 24 h after CFC training sessions. We evaluated whether RANTES levels could be differentially regulated at 12 and 24 h after CFC training; in Experiment 3, maraviroc was administered to rats (i.m: 100 mg/Kg, a CCR5 antagonist) before CFC training. These rats were not subjected to chronic stress restraint. We evaluated whether CCR5 blockade before CFC training could increase corticosterone, RANTES, or IL-6 levels and affects fear memory consolidation in the rats 24-h post-testing compared with vehicle CFC-trained rats. RESULTS Elevations of CCR5/RANTES chemokine levels in the hippocampus could have contributed to fear memory consolidation (24 h post-training) and chronic stress restraint did not affect these chemokines in the hippocampus; there were no significant differences in CCR5/RANTES levels between stressed and control rats in the prefrontal cortex (Experiment 1). In Experiment 2, hippocampal CCR5/RANTES levels increased and enhanced fear memory consolidation was observed 12 and 24 h after CFC training sessions with 1 mA of footshock. Increased corticosterone and CCR5/RANTES levels, as well as a higher freezing percentage to the context, were found at 24 h CFC post-testing in maraviroc-treated rats as compared to vehicle-treated animals (experiment-3). Conversely, IL-6 is not affected by maraviroc treatment in CFC training. CONCLUSION Our findings suggest a role for a hippocampal CCR5/RANTES axis in contextual fear memory consolidation; in fact, RANTES levels increased at 12 and 24 h after CFC training. When CCR5 was blocked by maraviroc before CFC training, RANTES (hippocampus), corticosterone levels, and fear memory consolidation were greater than in vehicle CFC-trained rats 24 h after the CFC session.
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Affiliation(s)
- José Joaquín Merino
- Dpto. Farmacología, Farmacognosia y Botánica, Facultad de Farmacia, Universidad Complutense de Madrid (U.C.M). c/ Plaza Ramón y Cajal s/n, 28040 Madrid, Spain
| | - Vilma Muñetón-Gomez
- Universidad de La Salle Center, Facultad de Ciencias Agropecuarias, Av. Carrera 7. # 179-03 (sede norte), Bogotá, Colombia; (V.M.-G.); (C.M.-G.)
| | - César Muñetón-Gómez
- Universidad de La Salle Center, Facultad de Ciencias Agropecuarias, Av. Carrera 7. # 179-03 (sede norte), Bogotá, Colombia; (V.M.-G.); (C.M.-G.)
| | | | - María Loscertales
- Harvard Medical School, MGH, Massachussets General Hospital, 185 Cambridge St, Boston, MA 02114, USA;
| | - Adolfo Toledano Gasca
- Department of Neuroanatomy, Instituto Cajal (CSIC), c/ Dr. Arce, 28.002 Madrid, Spain;
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Willing AE, Girling SA, Deichert R, Wood-Deichert R, Gonzalez J, Hernandez D, Foran E, Sanberg PR, Kip KE. Brazilian Jiu Jitsu Training for US Service Members and Veterans with Symptoms of PTSD. Mil Med 2019; 184:e626-e631. [PMID: 31004163 PMCID: PMC6910885 DOI: 10.1093/milmed/usz074] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2019] [Accepted: 03/15/2019] [Indexed: 11/14/2022] Open
Abstract
Introduction The United States has been actively involved in major armed conflicts over the last 15 years. As a result, a significant proportion of active duty service personnel and returning veterans have endured combat, putting them at risk for developing post-traumatic stress disorder (PTSD), a disabling disorder that may occur after exposure to a traumatic event. Current therapies often require long-term, time-intensive and costly commitment from the patient and have variable degrees of success. There remains an ongoing need for better therapies, including complementary medicine approaches that can effectively reduce PTSD symptoms. While anecdotal evidence suggests that routine practice of Brazilian Jiu Jitsu (BJJ) can reduce symptoms of PTSD, there have been no formal studies to address this. Materials and Methods This study was approved by the University of South Florida Institutional Review Board (#PRO00019430). Male US active duty service members and veterans from the Tampa area participated in a 5-month (40 sessions) BJJ training program. Before beginning and again midway through and upon completion of training the participants completed several validated self-report measures that addressed symptoms of PTSD and other co-morbid conditions. Effect size and 95% confidence intervals were determined using a within-person single-group pretest–posttest design. Results Study participants demonstrated clinically meaningful improvements in their PTSD symptoms as well as decreased symptoms of major depressive disorder, generalized anxiety and decreased alcohol use; effect sizes varied from 0.80 to 1.85. Conclusions The results from this first-of-kind pilot study suggest that including BJJ as a complementary treatment to standard therapy for PTSD may be of value. It will be necessary to validate these promising results with a larger subject cohort and a more rigorous experimental design before routinely recommending this complementary therapy.
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Affiliation(s)
- Alison E Willing
- Center for Excellence in Aging and Brain Repair, Department of Neurosurgery and Brain Repair, Morsani College of Medicine, University of South Florida, 3515 E. Fletcher, Tampa, FL 33613
| | - Sue Ann Girling
- College of Nursing, University of South Florida, 12901 Bruce B. Downs Blvd, Tampa, FL 33612
| | - Ryan Deichert
- Tampa Jiu Jitsu, LLC, 4210 Carnal Ave, Tampa, FL 33618
| | | | - Jason Gonzalez
- College of Nursing, University of South Florida, 12901 Bruce B. Downs Blvd, Tampa, FL 33612
| | - Diego Hernandez
- College of Nursing, University of South Florida, 12901 Bruce B. Downs Blvd, Tampa, FL 33612
| | - Elspeth Foran
- Center for Excellence in Aging and Brain Repair, Department of Neurosurgery and Brain Repair, Morsani College of Medicine, University of South Florida, 3515 E. Fletcher, Tampa, FL 33613
| | - Paul R Sanberg
- Center for Excellence in Aging and Brain Repair, Department of Neurosurgery and Brain Repair, Morsani College of Medicine, University of South Florida, 3515 E. Fletcher, Tampa, FL 33613.,Office of Research, Innovation & Knowledge Enterprise, University of South Florida, 3702 Spectrum Blvd. Ste. 165, Tampa, FL 33612
| | - Kevin E Kip
- Department of Epidemiology and Biostatistics, College of Public Health, University of South Florida, 13201 Bruce B. Downs Blvd, Tampa, FL 33612
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Espiridion ED, Gupta J, Bshara A, Danssaert Z. Transient Global Amnesia in a 60-year-old female with Post-traumatic Stress Disorder. Cureus 2019; 11:e5792. [PMID: 31728239 PMCID: PMC6827854 DOI: 10.7759/cureus.5792] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
This is a case report involving a 60-year-old female who developed transient global amnesia (TGA) after an emotional psychotherapy session in the framework of post-traumatic stress disorder (PTSD). She presented to the local emergency room, three days after her psychotherapist appointment, with complaints of memory impairment. She and her husband were worried about acute stroke since it was a sudden memory loss. The patient discussed with her psychotherapist a physical assault that occurred five years ago. Three days after that discussion, the patient developed the memory loss acutely. PTSD is associated with dissociative and retrograde amnesia. This case report demonstrates that PTSD can present with anterograde amnesia in the form of TGA.
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Affiliation(s)
| | - Jayesh Gupta
- Psychiatry, Drexel University College of Medicine, Philadelphia, USA
| | - Andre Bshara
- Medicine, Drexel University College of Medicine, Philadelphia, USA
| | - Zachary Danssaert
- Medicine, Philadelphia College of Osteopathic Medicine, Philadelphia, USA
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Bonanni L, Franciotti R, Martinotti G, Vellante F, Flacco ME, Di Giannantonio M, Thomas A, Onofrj M. Post Traumatic Stress Disorder Heralding the Onset of Semantic Frontotemporal Dementia. J Alzheimers Dis 2019; 63:203-215. [PMID: 29614666 PMCID: PMC5900559 DOI: 10.3233/jad-171134] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Background: Post traumatic stress disorder (PTSD) is associated with cognitive decline. The dementia type following PTSD is unclear. Objective: To assess whether PTSD is associated with a specific dementia. Methods: Prospective study: 46 PTSD patients (DSM-IV-TR) were followed for 6–10 years with clinical, neuropsychological, imaging evaluations for possible development of dementia. Retrospective study: 849 dementia patients followed during 1999–2014 (509 Alzheimer’s disease, AD; 207 dementia with Lewy bodies, DLB; 90 vascular dementia, VaD; 43 frontotemporal dementia, FTD) and 287 patients with any neurological condition (including patients with/without dementia) were evaluated for the presence of PTSD in their history. Results: Prospective study: 8 patients developed dementia; 1 AD, 1 DLB, 6 semantic FTD (13.0% of the PTSD population). Retrospective study: 38 patients (4.5%) had a history of PTSD; 3.5% of AD, 4.3% of DLB, 14.0% of FTD, 5.6% of VaD. The percentage was higher in FTD than in AD or DLB (χ2 = 10, p = 0.001, and χ2 = 6, p = 0.02). At difference with AD, DLB, or VaD, FTD incidence among dementia patients with PTSD history (38 patients) was higher than in the dementia population overall (16% versus 5%, χ2 = 8, p = 0.005). The impact of possible demographical/clinical confounders (age, gender, MMSE) was excluded by Poisson regression. PTSD prevalence in the comparative group without dementia matched the prevalence in the Italian general population (1.1%). PTSD prevalence in the demented comparative group matched the prevalence in our dementia retrospective cohort, 3.7%). Discussion: PTSD was associated with the development of semantic FTD.
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Affiliation(s)
- Laura Bonanni
- Department of Neuroscience Imaging and Clinical Sciences, University G. d'Annunzio of Chieti-Pescara, Chieti, Italy
| | - Raffaella Franciotti
- Department of Neuroscience Imaging and Clinical Sciences, University G. d'Annunzio of Chieti-Pescara, Chieti, Italy
| | - Giovanni Martinotti
- Department of Neuroscience Imaging and Clinical Sciences, University G. d'Annunzio of Chieti-Pescara, Chieti, Italy
| | - Federica Vellante
- Department of Neuroscience Imaging and Clinical Sciences, University G. d'Annunzio of Chieti-Pescara, Chieti, Italy
| | | | - Massimo Di Giannantonio
- Department of Neuroscience Imaging and Clinical Sciences, University G. d'Annunzio of Chieti-Pescara, Chieti, Italy
| | - Astrid Thomas
- Department of Neuroscience Imaging and Clinical Sciences, University G. d'Annunzio of Chieti-Pescara, Chieti, Italy
| | - Marco Onofrj
- Department of Neuroscience Imaging and Clinical Sciences, University G. d'Annunzio of Chieti-Pescara, Chieti, Italy
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36
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Shytle RD, Eve DJ, Kim SH, Spiegel A, Sanberg PR, Borlongan CV. Retrospective Case Series of Traumatic Brain Injury and Post-Traumatic Stress Disorder Treated with Hyperbaric Oxygen Therapy. Cell Transplant 2019; 28:885-892. [PMID: 31134828 PMCID: PMC6719491 DOI: 10.1177/0963689719853232] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Returning veterans are frequently diagnosed with traumatic brain injury (TBI) and post-traumatic stress disorder (PTSD). Considering a recent case-controlled study of hyperbaric oxygen therapy (HBOT) reporting a reduction in suicidal ideation, we investigated retrospectively three veterans with chronic TBI/PTSD symptoms who were treated with multiple rounds of HBOT with neurophysiological testing performed before and after treatment. Improvements were detected on parameters within neurocognitive domains, including reductions in suicide-related symptoms. These findings independently confirm that HBOT may be effective in treating specific symptoms of TBI/PTSD that are not currently addressed with existing therapeutic approaches.
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Affiliation(s)
- R Douglas Shytle
- 1 Center of Excellence for Aging and Brain Repair, Department of Neurosurgery and Brain Repair, Morsani College of Medicine, University of South Florida, Tampa, USA
| | - David J Eve
- 1 Center of Excellence for Aging and Brain Repair, Department of Neurosurgery and Brain Repair, Morsani College of Medicine, University of South Florida, Tampa, USA
| | - Soel-Hee Kim
- 1 Center of Excellence for Aging and Brain Repair, Department of Neurosurgery and Brain Repair, Morsani College of Medicine, University of South Florida, Tampa, USA
| | | | - Paul R Sanberg
- 1 Center of Excellence for Aging and Brain Repair, Department of Neurosurgery and Brain Repair, Morsani College of Medicine, University of South Florida, Tampa, USA
| | - Cesar V Borlongan
- 1 Center of Excellence for Aging and Brain Repair, Department of Neurosurgery and Brain Repair, Morsani College of Medicine, University of South Florida, Tampa, USA
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Vaudreuil R, Bronson H, Bradt J. Bridging the Clinic to Community: Music Performance as Social Transformation for Military Service Members. Front Psychol 2019; 10:119. [PMID: 30804832 PMCID: PMC6370624 DOI: 10.3389/fpsyg.2019.00119] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2018] [Accepted: 01/14/2019] [Indexed: 01/14/2023] Open
Abstract
The use of music performance in music therapy with military service members is discussed as a vehicle for social transformation and reintegration. The use of performance in music therapy is not without controversy primarily because therapy is considered a process, not a product, and confidentiality and privacy are essential components of therapy. However, others have argued that public performances can validate therapeutic changes in clients, give voice to their experiences, raise awareness of social issues within their communities, transform perceptions of injury, or illness in audience members, and may result in the clients gaining support and validation from their communities. We discuss the potential of music performances to contribute to individual development, reinforce rehabilitation, enhance function, and facilitate change at the community level to support reintegration of military service members. We illustrate this through two brief case reports of service members who received music therapy as part of their treatment for post-traumatic stress disorder, traumatic brain injury, and other psychological health concerns at the National Intrepid Center of Excellence, a Directorate of the Walter Reed National Military Medical Center, Bethesda, MD, United States. The service members wrote, learned, and refined songs over multiple music therapy sessions and created song introductions to share with audiences the meanings and benefits gained from integrating performance in music therapy. The case reports also include excerpts of interviews conducted with these service members several months after treatment about their experiences of performing and the perceived impact of their performances on the audience and greater community.
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Affiliation(s)
- Rebecca Vaudreuil
- National Endowment for the Arts, Washington, DC, United States.,National Intrepid Center of Excellence, Bethesda, MD, United States
| | - Hannah Bronson
- National Endowment for the Arts, Washington, DC, United States
| | - Joke Bradt
- Department of Creative Arts Therapies, Drexel University, Philadelphia, PA, United States
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38
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Steelman B. Attachment-based therapy for elder suffering PTSD symptoms: A narrative of modeling efficacy for improved outcomes. Perspect Psychiatr Care 2019; 55:72-74. [PMID: 29897630 DOI: 10.1111/ppc.12300] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2018] [Accepted: 05/21/2018] [Indexed: 11/30/2022] Open
Abstract
PURPOSE This paper will acquaint the psychiatric nurse with attachment theory-based therapy through a narrative of post traumatic stress disorder (PTSD) treatment of a Vietnam veteran with a history of compound trauma in childhood. DESIGN AND METHODS Application of attachment-based therapy is discussed within the context of its guiding principles and tenets. FINDINGS Attachment-based therapy is effective in reducing PTSD symptoms in a Vietnam veteran through forming secure base scripts from which the patient better evaluated and managed stressors, resulting in improved life functioning. PRACTICE IMPLICATIONS Attachment theory provides valuable tools with which to treat PTSD sufferers by utilizing nurses' expert skills in establishing rapport and relationship building to form the basis of effectual therapy.
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39
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Lim PH, Shi G, Wang T, Jenz ST, Mulligan MK, Redei EE, Chen H. Genetic Model to Study the Co-Morbid Phenotypes of Increased Alcohol Intake and Prior Stress-Induced Enhanced Fear Memory. Front Genet 2018; 9:566. [PMID: 30538720 PMCID: PMC6277590 DOI: 10.3389/fgene.2018.00566] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2018] [Accepted: 11/06/2018] [Indexed: 01/08/2023] Open
Abstract
Posttraumatic Stress Disorder (PTSD) is a complex illness, frequently co-morbid with depression, caused by both genetics, and the environment. Alcohol Use Disorder (AUD), which also co-occurs with depression, is often co-morbid with PTSD. To date, very few genes have been identified for PTSD and even less for PTSD comorbidity with AUD, likely because of the phenotypic heterogeneity seen in humans, combined with each gene playing a relatively small role in disease predisposition. In the current study, we investigated whether a genetic model of depression-like behavior, further developed from the depression model Wistar Kyoto (WKY) rat, is a suitable vehicle to uncover the genetics of co-morbidity between PTSD and AUD. The by-now inbred WKY More Immobile (WMI) and the WKY Less Immobile (WLI) rats were generated from the WKY via bidirectional selective breeding using the forced swim test, a measure of despair-like behavior, as the functional selector. The colonies of the WMIs that show despair-like behavior and the control strain showing less or no despair-like behavior, the WLI, are maintained with strict inbreeding over 40 generations to date. WMIs of both sexes intrinsically self-administer more alcohol than WLIs. Alcohol self-administration is increased in the WMIs without sucrose fading, water deprivation or any prior stress, mimicking the increased voluntary alcohol-consumption of subjects with AUD. Prior Stress-Enhanced Fear Learning (SEFL) is a model of PTSD. WMI males, but not females, show increased SEFL after acute restraint stress in the context-dependent fear conditioning paradigm, a sexually dimorphic pattern similar to human data. Plasma corticosterone differences between stressed and not-stressed WLI and WMI male and female animals immediately prior to fear conditioning predict SEFL results. These data demonstrate that the WMI male and its genetically close, but behaviorally divergent control the WLI male, would be suitable for investigating the underlying genetic basis of comorbidity between SEFL and alcohol self-administration.
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Affiliation(s)
- Patrick Henry Lim
- Department of Psychiatry and Behavioral Science, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
| | - Guang Shi
- Liaoning Provincial People's Hospital, Liaoning Sheng, China
| | - Tengfei Wang
- Department of Pharmacology, University of Tennessee Health Science Center, Memphis, TN, United States
| | - Sophia T Jenz
- Department of Psychiatry and Behavioral Science, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
| | - Megan K Mulligan
- Department of Genetics Genomics and Informatics, University of Tennessee Health Science Center, Memphis, TN, United States
| | - Eva E Redei
- Department of Psychiatry and Behavioral Science, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States
| | - Hao Chen
- Department of Pharmacology, University of Tennessee Health Science Center, Memphis, TN, United States
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Tatar ZB, Yüksel Ş. Mobbing at Workplace -Psychological Trauma and Documentation of Psychiatric Symptoms. ACTA ACUST UNITED AC 2018; 56:57-62. [PMID: 30911239 DOI: 10.29399/npa.22924] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [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: 10/03/2017] [Accepted: 03/30/2018] [Indexed: 11/07/2022]
Abstract
Objectives Mobbing at the workplace refers to such cases as verbal harassment, aggressive words, sarcasm, slander or social isolation repeatedly targeted at a specific person at a specific period of time. Previous studies indicate that wellness and health of the victims who have been subjected to mobbing at workplace were affected adversely. Recently, there has been an increase in mobbing cases in Turkey. The purpose of the present study is to identify the features of trauma and analyse the development of mental problems caused by traumatic experiences in individuals who have been subjected to mobbing at workplace, and admitted to psychiatry services. Method Three-hundred individuals included in the study who had been admitted to Istanbul University, Istanbul Faculty of Medicine, Psychiatry Department, Psychosocial Trauma Programme, through general psychiatry outpatient clinics and forensic medicine institute consultations, with the purpose of preparing forensic reports between January 2008-September 2012. Trauma Evaluation Form (TIF), Posttraumatic Stress Diagnostic Scale (PDS), Impact of Event Scale-Revised (IES-R) were administered. Results Mobbing was identified in 130 out of 300 patients who claimed to have been subjected to trauma at workplace (43.3%). Mobbing cases were aged between 18 and 61, 100 (76.9%) of them were women. 56 (43%) of the cases were married, 54 (41.5%) of them were single and others were divorced, widowed or separated. 110 (84.6%) of the patients were university graduates while 13 of them were high school graduates and 5 of them were elementary school graduates. 76 of the cases were government officers and 65 of them were teachers. 93 (71.5%) patients were diagnosed with post-traumatic stress disorder (PTSD) according to The Diagnostic and Statistical Manual of Mental Disorders Fourth Edition-Revised (DSM-IV-TR) criteria, 9 patients (6.9%) had adjustment disorder and 102 of the patients (78.5%) were diagnosed with Major Depressive Disorder. Mean Total IES of 122 patients was 58.4±16.7. Three persons (2.3%) had not received any diagnoses and 83 individuals (63.8%) had received multiple diagnoses. Conclusion The fact that mobbing was identified in approximately half of cases who applied to get a forensic report points out the extensiveness of the problem. High percentage of PTSD was established in victims of mobbing. It is important to include psychologic trauma in definiton of trauma in manuals of psychiatric disorders. Preparation of a report is useful in helping these individuals to protect their legal rights as well as documenting these wrongdoings, improving the sense of justice, enabling these individuals to be examined by psychiatry experts and having them access to treatment.
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Affiliation(s)
- Zeynep Baran Tatar
- Department of Psychiatry, Bakırköy Mental and Neurological Diseases Training and Research Hospital, İstanbul, Turkey
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Abstract
Post traumatic stress disorder (PTSD) may first emerge, reemerge, or worsen as individuals approach end of life and may complicate the dying process. Unfortunately, lack of awareness of the occurrence and/or manifestation of PTSD at end of life can lead to PTSD going unaddressed. Even if PTSD is properly diagnosed, traditional evidence-based trauma-focused treatments may not be feasible or advisable with this group as many patients at end of life often lack the physical and mental stamina to participate in traditional psychotherapy. This article reviews the clinical and empirical literature on PTSD at end of life, as well as discusses assessment and psychotherapy treatment issues with this neglected population. In addition, it expands on the current reviews of this literature1-3 by extrapolating results from nontraditional treatment approaches with other patient populations. Elements of these approaches with patients sharing similar characteristics and/or comorbidities with patients with PTSD at end of life may provide additional benefits for the latter population. Clinical implications and suggestions for interdisciplinary care providers are provided.
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Affiliation(s)
- Debra M. Glick
- National Center for PTSD, VA Boston Healthcare System, Boston, MA, USA
| | - Joan M. Cook
- National Center for PTSD, VA Connecticut Healthcare System and Yale University School of Medicine, New Haven, CT, USA
| | - Jennifer Moye
- VA Boston Healthcare System and Harvard Medical School, Boston, MA, USA
| | - Anica Pless Kaiser
- National Center for PTSD, VA Boston Healthcare System and Boston University School of Medicine, Boston, MA, USA
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Sijbrandij M. Expanding the evidence: key priorities for research on mental health interventions for refugees in high-income countries. Epidemiol Psychiatr Sci 2018; 27:105-8. [PMID: 29143713 DOI: 10.1017/S2045796017000713] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/23/2023] Open
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Harch PG, Andrews SR, Fogarty EF, Lucarini J, Van Meter KW. Case control study: hyperbaric oxygen treatment of mild traumatic brain injury persistent post-concussion syndrome and post-traumatic stress disorder. Med Gas Res 2017; 7:156-174. [PMID: 29152209 PMCID: PMC5674654 DOI: 10.4103/2045-9912.215745] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023] Open
Abstract
Mild traumatic brain injury (TBI) persistent post-concussion syndrome (PPCS) and post-traumatic stress disorder (PTSD) are epidemic in United States Iraq and Afghanistan War veterans. Treatment of the combined diagnoses is limited. The aim of this study is to assess safety, feasibility, and effectiveness of hyperbaric oxygen treatments (HBOT) for mild TBI PPCS and PTSD. Thirty military subjects aged 18-65 with PPCS with or without PTSD and from one or more blast-induced mild-moderate traumatic brain injuries that were a minimum of 1 year old and occurred after 9/11/2001 were studied. The measures included symptom lists, physical exam, neuropsychological and psychological testing on 29 subjects (1 dropout) and SPECT brain imaging pre and post HBOT. Comparison was made using SPECT imaging on 29 matched Controls. Side effects (30 subjects) experienced due to the HBOT: reversible middle ear barotrauma (n = 6), transient deterioration in symptoms (n = 7), reversible bronchospasm (n = 1), and increased anxiety (n = 2; not related to confinement); unrelated to HBOT: ureterolithiasis (n = 1), chest pain (n = 2). Significant improvement (29 subjects) was seen in neurological exam, symptoms, intelligence quotient, memory, measures of attention, dominant hand motor speed and dexterity, quality of life, general anxiety, PTSD, depression (including reduction in suicidal ideation), and reduced psychoactive medication usage. At 6-month follow-up subjects reported further symptomatic improvement. Compared to Controls the subjects' SPECT was significantly abnormal, significantly improved after 1 and 40 treatments, and became statistically indistinguishable from Controls in 75% of abnormal areas. HBOT was found to be safe and significantly effective for veterans with mild to moderate TBI PPCS with PTSD in all four outcome domains: clinical medicine, neuropsychology, psychology, and SPECT imaging. Veterans also experienced a significant reduction in suicidal ideation and reduction in psychoactive medication use.
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Affiliation(s)
- Paul G Harch
- Louisiana State University School of Medicine, New Orleans, LA, USA
| | - Susan R Andrews
- Louisiana State University School of Medicine, New Orleans, LA, USA
| | - Edward F Fogarty
- University of North Dakota School of Medicine, Bismarck, ND, USA
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Tay AK, Rees S, Steel Z, Liddell B, Nickerson A, Tam N, Silove D. The role of grief symptoms and a sense of injustice in the pathways to post-traumatic stress symptoms in post-conflict Timor-Leste. Epidemiol Psychiatr Sci 2017; 26:403-13. [PMID: 27573421 DOI: 10.1017/S2045796016000317] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
AIMS Grief symptoms and a sense of injustice may be interrelated responses amongst persons exposed to mass conflict and both reactions may contribute to post-traumatic stress disorder (PTSD) symptoms. As yet, however, there is a dearth of data examining these relationships. Our study examined the contributions of grief and a sense of injustice to a model of PTSD symptoms that included the established determinants of trauma events, ongoing adversity and severe psychological distress. The study involved a large population sample (n = 2964, response rate: 82.4%) surveyed in post-conflict Timor-Leste. METHODS The survey sites included an urban administrative area (suco) in Dili, the capital of Timor-Leste and a rural village located an hour's drive away. Culturally adapted measures were applied to assess conflict related traumatic events (TEs), ongoing adversity, persisting preoccupations with injustice, symptoms of grief, psychological distress (including depressive symptoms) and PTSD symptoms. RESULTS We tested a series of structural equation models, the final comprehensive model, which included indices of grief symptoms and injustice, producing a good fit. Locating grief symptoms as the endpoint of the model produced a non-converging model. In the final model, strong associations were evident between grief and injustice (β = 0.34, s.e. = 0.02, p < 0.01) and grief and PTSD symptoms (β = 0.14, s.e. = 0.02, p < 0.01). The sense of injustice exerted a considerable effect on PTSD symptoms (β = 0.13, s.e. = 0.03, p < 0.01). In addition, multiple indirect paths were evident, most involving grief and a sense of injustice, attesting to the complex inter-relationship of these factors in contributing to PTSD symptoms. CONCLUSIONS Our findings support an expanded model of PTSD symptoms relevant to post-conflict populations, in which grief symptoms and a sense of injustice play pivotal roles. The model supports the importance of a focus on loss, grief and a sense of injustice in conducting trauma-focused psychotherapies for PTSD amongst populations exposed to mass conflict and violence. Further research is needed to identify the precise mechanisms whereby grief symptoms and the sense of injustice impact on PTSD symptoms.
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Mills KL, Barrett EL, Merz S, Rosenfeld J, Ewer PL, Sannibale C, Baker AL, Hopwood S, Back SE, Brady KT, Teesson M. Integrated Exposure-Based Therapy for Co-Occurring Post Traumatic Stress Disorder (PTSD) and Substance Dependence: Predictors of Change in PTSD Symptom Severity. J Clin Med 2016; 5:jcm5110101. [PMID: 27854264 PMCID: PMC5126798 DOI: 10.3390/jcm5110101] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2016] [Revised: 10/26/2016] [Accepted: 11/08/2016] [Indexed: 11/26/2022] Open
Abstract
This paper examines factors associated with change in PTSD symptom severity among individuals randomised to receive an integrated exposure-based psychotherapy for PTSD and substance dependence–Concurrent Treatment of PTSD and Substance Use Disorders Using Prolonged Exposure (COPE). Outcomes examined include change in PTSD symptom severity as measured by the Clinician Administered PTSD Scale (CAPS), and the reliability and clinical significance of change in PTSD symptom severity. Factors examined include patient baseline characteristics, treatment characteristics, and events over follow-up. The mean difference in CAPS score was 38.24 (SE 4.81). Approximately half (49.1%) demonstrated a reliable and clinically significant improvement in PTSD symptom severity. No one was classified as having demonstrated clinically significant worsening of symptoms. Three independent predictors of reductions in PTSD symptom severity were identified: baseline PTSD symptom severity (β 0.77, SE 0.23, p = 0.001), number of traumas experienced prior to baseline (β −0.30, SE 0.15, p = 0.049), and number of sessions attended (β 2.05, SE 0.87, p = 0.024). The present study provides further evidence regarding the safety of the COPE treatment and factors associated with improvement in PTSD symptom severity. The identification of only a small number of predictors of the outcome points to the broad applicability of the COPE treatment to PTSD and substance use disorder (SUD) patients.
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Affiliation(s)
- Katherine L Mills
- National Drug & Alcohol Research Centre, University of New South Wales, Sydney 2052, NSW, Australia.
- Centre of Research Excellence in Mental Health and Substance Use, University of New South Wales, Sydney 2052, NSW, Australia.
| | - Emma L Barrett
- National Drug & Alcohol Research Centre, University of New South Wales, Sydney 2052, NSW, Australia.
- Centre of Research Excellence in Mental Health and Substance Use, University of New South Wales, Sydney 2052, NSW, Australia.
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC 29425, USA.
| | - Sabine Merz
- National Drug & Alcohol Research Centre, University of New South Wales, Sydney 2052, NSW, Australia.
| | - Julia Rosenfeld
- National Drug & Alcohol Research Centre, University of New South Wales, Sydney 2052, NSW, Australia.
| | - Philippa L Ewer
- National Drug & Alcohol Research Centre, University of New South Wales, Sydney 2052, NSW, Australia.
- Centre of Research Excellence in Mental Health and Substance Use, University of New South Wales, Sydney 2052, NSW, Australia.
| | - Claudia Sannibale
- National Drug & Alcohol Research Centre, University of New South Wales, Sydney 2052, NSW, Australia.
| | - Amanda L Baker
- School of Medicine and Public Health, University of Newcastle, Callaghan 2308, NSW, Australia.
| | - Sally Hopwood
- School of Psychology, University of New South Wales, Sydney 2052, NSW, Australia.
| | - Sudie E Back
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC 29425, USA.
| | - Kathleen T Brady
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC 29425, USA.
| | - Maree Teesson
- National Drug & Alcohol Research Centre, University of New South Wales, Sydney 2052, NSW, Australia.
- Centre of Research Excellence in Mental Health and Substance Use, University of New South Wales, Sydney 2052, NSW, Australia.
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Pollard HB, Shivakumar C, Starr J, Eidelman O, Jacobowitz DM, Dalgard CL, Srivastava M, Wilkerson MD, Stein MB, Ursano RJ. "Soldier's Heart": A Genetic Basis for Elevated Cardiovascular Disease Risk Associated with Post-traumatic Stress Disorder. Front Mol Neurosci 2016; 9:87. [PMID: 27721742 PMCID: PMC5033971 DOI: 10.3389/fnmol.2016.00087] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2016] [Accepted: 09/05/2016] [Indexed: 11/13/2022] Open
Abstract
"Soldier's Heart," is an American Civil War term linking post-traumatic stress disorder (PTSD) with increased propensity for cardiovascular disease (CVD). We have hypothesized that there might be a quantifiable genetic basis for this linkage. To test this hypothesis we identified a comprehensive set of candidate risk genes for PTSD, and tested whether any were also independent risk genes for CVD. A functional analysis algorithm was used to identify associated signaling networks. We identified 106 PTSD studies that report one or more polymorphic variants in 87 candidate genes in 83,463 subjects and controls. The top upstream drivers for these PTSD risk genes are predicted to be the glucocorticoid receptor (NR3C1) and Tumor Necrosis Factor alpha (TNFA). We find that 37 of the PTSD candidate risk genes are also candidate independent risk genes for CVD. The association between PTSD and CVD is significant by Fisher's Exact Test (P = 3 × 10-54). We also find 15 PTSD risk genes that are independently associated with Type 2 Diabetes Mellitus (T2DM; also significant by Fisher's Exact Test (P = 1.8 × 10-16). Our findings offer quantitative evidence for a genetic link between post-traumatic stress and cardiovascular disease, Computationally, the common mechanism for this linkage between PTSD and CVD is innate immunity and NFκB-mediated inflammation.
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Affiliation(s)
- Harvey B Pollard
- Department of Anatomy, Physiology and Genetics, Uniformed Services University School of Medicine, Uniformed Services University of the Health SciencesBethesda, MD, USA; Collaborative Health Initiative Research Program, Uniformed Services University of the Health SciencesBethesda, MD, USA
| | - Chittari Shivakumar
- Collaborative Health Initiative Research Program, Uniformed Services University of the Health Sciences Bethesda, MD, USA
| | - Joshua Starr
- Department of Anatomy, Physiology and Genetics, Uniformed Services University School of Medicine, Uniformed Services University of the Health Sciences Bethesda, MD, USA
| | - Ofer Eidelman
- Department of Anatomy, Physiology and Genetics, Uniformed Services University School of Medicine, Uniformed Services University of the Health Sciences Bethesda, MD, USA
| | - David M Jacobowitz
- Collaborative Health Initiative Research Program, Uniformed Services University of the Health Sciences Bethesda, MD, USA
| | - Clifton L Dalgard
- Department of Anatomy, Physiology and Genetics, Uniformed Services University School of Medicine, Uniformed Services University of the Health SciencesBethesda, MD, USA; Collaborative Health Initiative Research Program, Uniformed Services University of the Health SciencesBethesda, MD, USA
| | - Meera Srivastava
- Department of Anatomy, Physiology and Genetics, Uniformed Services University School of Medicine, Uniformed Services University of the Health Sciences Bethesda, MD, USA
| | - Matthew D Wilkerson
- Collaborative Health Initiative Research Program, Uniformed Services University of the Health Sciences Bethesda, MD, USA
| | - Murray B Stein
- Department of Psychiatry, University of California, San Diego San Diego, CA, USA
| | - Robert J Ursano
- Department of Psychiatry Uniformed Services University School of Medicine, Uniformed Services University of the Health SciencesBethesda, MD, USA; Center for the Study of Traumatic stress, Uniformed Services University of the Health SciencesBethesda, MD, USA
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Abstract
This article reviews possible ways that traumatic brain injury (TBI) can induce migraine-type post-traumatic headaches (PTHs) in children, adults, civilians, and military personnel. Several cerebral alterations resulting from TBI can foster the development of PTH, including neuroinflammation that can activate neural systems associated with migraine. TBI can also compromise the intrinsic pain modulation system and this would increase the level of perceived pain associated with PTH. Depression and anxiety disorders, especially post-traumatic stress disorder (PTSD), are associated with TBI and these psychological conditions can directly intensify PTH. Additionally, depression and PTSD alter sleep and this will increase headache severity and foster the genesis of PTH. This article also reviews the anatomic loci of injury associated with TBI and notes the overlap between areas of injury associated with TBI and PTSD.
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Abstract
Objective Veterans of war affected by posttraumatic stress disorder (PTSD) are at increased risk for cardiovascular diseases. We aimed to compare brachial and central blood pressures between veterans with PTSD and controls. Method In this case-control study on veterans of Iran-Iraq war, 50 veterans with PTSD and 50 veterans as controls were selected from an outpatient clinic and matched for age ±3 years. Exclusion criteria were malignancies, severe anatomical defects such as amputated extremities, history of PTSD before serving in war, comorbid psychiatric disorders other than anxiety or depressive disorders. Detailed history was taken concerning medical and social aspects. Beck Depression Inventory was used for depressive symptoms. Brachial blood pressures were measured using both auscultatory and oscillometric devices. Measures of central hemodynamics were estimated accordingly. Data on lipid profile were collected either through medical records or newly required lab tests. Results Brachial systolic, diastolic, and pulse pressures as well as estimated central systolic and diastolic pressures were significantly higher in the PTSD group. Beck Depression Inventory scores, frequency of diabetes mellitus, and hypertension were significantly higher in the PTSD group. PTSD status was an independent predictor of both brachial and central systolic and diastolic pressures. Conclusions We demonstrated increased measures of blood pressure in veterans with PTSD independent of depression and other risk factors. Further research is warranted to confirm our results.
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Affiliation(s)
- Ehsan Moazen-Zadeh
- 1 Modern Epidemiology Research Center, Aja University of Medical Sciences, Tehran, Iran
- 2 Psychiatric Research Center, Roozbeh Hospital, Tehran University of Medical Sciences, Tehran, Iran
- 3 Mental Health Research Center, Tehran Institute of Psychiatry, School of Behavioral Sciences and Mental Health, Iran University of Medical Sciences, Tehran, Iran
| | - Alireza Khoshdel
- 1 Modern Epidemiology Research Center, Aja University of Medical Sciences, Tehran, Iran
| | - Farhad Avakh
- 4 Faculty of Aerospace and Diving Medicine, Aja University of Medical Sciences, Tehran, Iran
| | - Arash Rahmani
- 3 Mental Health Research Center, Tehran Institute of Psychiatry, School of Behavioral Sciences and Mental Health, Iran University of Medical Sciences, Tehran, Iran
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Frissa S, Hatch SL, Fear NT, Dorrington S, Goodwin L, Hotopf M. Challenges in the retrospective assessment of trauma: comparing a checklist approach to a single item trauma experience screening question. BMC Psychiatry 2016; 16:20. [PMID: 26830818 DOI: 10.1186/s12888-016-0720-1] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2015] [Accepted: 01/18/2016] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Research on trauma and its impact on mental health typically relies on self-reports which can be influenced by recall bias and an individual's subjective interpretation of events. This study aims to compare responses on a checklist of life events with a trauma experience screening question, both of which assessed trauma experience retrospectively. METHODS A community sample of adults were asked about life events from a checklist before asking them whether they ever had a trauma experience, i.e. "an event that either puts them or someone close to them at risk of serious harm or death". RESULTS Less than half of the sample who reported at least one life event on the checklist that qualified as a trauma reported a trauma experience that they perceived put them or close others at risk of serious harm. Women responders, those reporting early life traumas, and a greater number of lifetime trauma events were more likely to report a trauma experience. Current symptoms of Common Mental Disorder did not account for differences in reporting of trauma experiences. CONCLUSIONS Epidemiological approaches which require participants to make subjective judgement on the severity of the trauma experience will capture individual differences that we have shown are influenced by gender and previous trauma experience.
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Abstract
As a part of an ongoing clinical study of refugees with post traumatic stress disorder (PTSD), the primary objective of the current study was to examine and describe the distribution of adult attachment patterns as assessed by the Adult Attachment Interview (AAI) in Arabic-speaking refugees. A total of 43 adult male and female refugees with Iraqi and Palestinian backgrounds completed the AAI. Sixty-seven percent of the sample was classified as Unresolved with respect to loss or trauma and a substantial proportion of insecure attachment representations (14% Secure-Autonomous, 39% Dismissing, 42% Preoccupied, 5% Cannot Classify) was found, in addition to high intake levels of post traumatic stress symptoms and comorbidity. Findings are compared with AAI studies of other PTSD or trauma samples, and the paper elaborates upon the methodological challenges in administering the AAI in a context of simultaneous translation.
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Affiliation(s)
- Karin Riber
- a Department of Psychology , University of Copenhagen , Copenhagen , Denmark.,b Competence Center for Transcultural Psychiatry , Copenhagen , Denmark
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