1
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Mac Dhonnagáin N, O'Reilly A, Shevlin M, Dooley B. Examining Predictors of Psychological Distress Among Youth Engaging with Jigsaw for a Brief Intervention. Child Psychiatry Hum Dev 2024; 55:731-743. [PMID: 36169770 PMCID: PMC11061019 DOI: 10.1007/s10578-022-01436-2] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/02/2022] [Indexed: 11/29/2022]
Abstract
Risk factors for psychological distress among help-seeking youth are poorly understood. Addressing this gap is important for informing mental health service provision. This study aimed to identify risk factors among youth attending Jigsaw, a youth mental health service in Ireland. Routine data were collected from N = 9,673 youth who engaged with Jigsaw (Mean age = 16.9 years, SD = 3.14), including presenting issues, levels of psychological distress, age, and gender. Confirmatory Factor Analysis identified thirteen factors of clustering issues. Several factors, including Self-criticism and Negative Thoughts, were strongly associated with items clustering as psychological distress, however these factors were poorly predictive of distress as measured by the CORE (YP-CORE: R2 = 14.7%, CORE-10: R2 = 6.9%). The findings provide insight into associations between young people's identified presenting issues and self-identified distress. Implications include applying appropriate therapeutic modalities to focus on risk factors and informing routine outcome measurement in integrated youth mental health services.
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Affiliation(s)
| | - Aileen O'Reilly
- School of Psychology, University College Dublin, Dublin, Ireland
- Jigsaw-The National Centre for Youth Mental Health, Dublin, Ireland
| | - Mark Shevlin
- School of Psychology, Ulster University, Coleraine, UK
| | - Barbara Dooley
- School of Psychology, University College Dublin, Dublin, Ireland
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2
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Butter S, Shevlin M, Gibson-Miller J, McBride O, Hartman TK, Bentall RP, Bennett K, Murphy J, Mason L, Martinez AP, Levita L. Psychological distress, wellbeing and resilience: modelling adolescent mental health profiles during the COVID-19 pandemic. Discov Ment Health 2024; 4:16. [PMID: 38780717 DOI: 10.1007/s44192-024-00071-8] [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] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Accepted: 05/21/2024] [Indexed: 05/25/2024]
Abstract
There has been concern about adolescent mental health during the pandemic. The current study examined adolescent mental health during the initial phase of the COVID-19 pandemic in the UK. Using indicator of psychological distress, wellbeing and resilience, latent profile analysis was used to identify homogeneous mental health groups among young people aged 13-24 (N = 1971). Multinomial logistic regression was then used to examine which sociodemographic and psychosocial variables predicted latent class membership. Four classes were found. The largest class (Class 1, 37.2%) was characterised by moderate symptomology and moderate wellbeing. Class 2 (34.2%) was characterised by low symptomology and high wellbeing, while Class 3 (25.4%) was characterised by moderate symptomology and high wellbeing. Finally, Class 4 was the smallest (3.2%) and was characterised by high symptomology and low wellbeing. Compared to the low symptomology, high wellbeing class, all other classes were associated with less social engagement with friends, poorer family functioning, greater somatic symptoms, and a less positive model of self. A number of unique associations between the classes and predictor variables were identified. Although around two-thirds of adolescents reported moderate-to-high symptomology, most of these individuals also reported concurrent moderate-to-high levels of wellbeing, reflecting resilience. Furthermore, these findings demonstrate how a more comprehensive picture of mental health can be gained through adopting a dual-continua conceptualisation of mental health that incorporates both pathology and well-being. In this way, at-risk youth can be identified and interventions and resources targeted appropriately.
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Affiliation(s)
- Sarah Butter
- School of Psychology, Ulster University, Cromore Road, Coleraine, BT52 1SA, Northern Ireland.
| | - Mark Shevlin
- School of Psychology, Ulster University, Cromore Road, Coleraine, BT52 1SA, Northern Ireland
| | | | - Orla McBride
- School of Psychology, Ulster University, Cromore Road, Coleraine, BT52 1SA, Northern Ireland
| | - Todd K Hartman
- Department of Social Statistics, University of Manchester, Manchester, England
| | - Richard P Bentall
- Department of Psychology, University of Sheffield, Sheffield, England
| | - Kate Bennett
- Department of Psychology, University of Liverpool, Liverpool, England
| | - Jamie Murphy
- School of Psychology, Ulster University, Cromore Road, Coleraine, BT52 1SA, Northern Ireland
| | - Liam Mason
- Division of Psychology and Language Sciences, University College London, London, England
| | - Anton P Martinez
- Department of Psychology, University of Sheffield, Sheffield, England
| | - Liat Levita
- School of Psychology, University of Sussex, Falmer, England
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3
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Bressington D, Hyland P, Steele H, Byrne M, Mitchell D, Keane C, Shevlin M, Ho G, Murta JCD, Easpaig BNG, Liu X, Zhai J, Murphy D, Karatzias T. ICD-11 post-traumatic stress disorder and complex post-traumatic stress disorder in mental health support-seeking former-serving Australian defence force veterans. Aust N Z J Psychiatry 2024; 58:416-424. [PMID: 38332613 DOI: 10.1177/00048674241230197] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/10/2024]
Abstract
BACKGROUND ICD-11 complex post-traumatic stress disorder is a more severe condition than post-traumatic stress disorder, and recent studies indicate it is more prevalent among military samples. In this study, we tested the psychometric properties of the International Trauma Questionnaire, assessed the relative prevalence rates of post-traumatic stress disorder and complex post-traumatic stress disorder in the sample population and explored relationships between complex post-traumatic stress disorder and post-traumatic stress disorder and a range of risk factors. METHODS Survey participants (N = 189) were mental health support-seeking former-serving veterans of the Australian Defence Force (ADF) recruited from primary care. Confirmatory factor analysis was used to test the factorial validity of the International Trauma Questionnaire. RESULTS The latent structure of the International Trauma Questionnaire was best represented by a two-factor second-order model consistent with the ICD-11 model of complex post-traumatic stress disorder. The International Trauma Questionnaire scale scores demonstrated excellent internal reliability. Overall, 9.1% (95% confidence interval = [4.8%, 13.5%]) met diagnostic requirements for post-traumatic stress disorder and an additional 51.4% (95% confidence interval = [44.0%, 58.9%]) met requirements for complex post-traumatic stress disorder. Those meeting diagnostic requirements for complex post-traumatic stress disorder were more likely to have served in the military for 15 years or longer, had a history of more traumatic life events and had the highest levels of depression, anxiety and stress symptoms. CONCLUSION The International Trauma Questionnaire can effectively distinguish between post-traumatic stress disorder and complex post-traumatic stress disorder within primary care samples of Australian Defence Force veterans. A significantly greater proportion of Australian Defence Force veterans met criteria for complex post-traumatic stress disorder than post-traumatic stress disorder. Australian military mental health services should adopt the International Trauma Questionnaire to routinely screen for complex post-traumatic stress disorder and develop complex post-traumatic stress disorder specific interventions to promote recovery in Australian Defence Force veterans with complex post-traumatic stress disorder.
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Affiliation(s)
| | - Philip Hyland
- Department of Psychology, Maynooth University, Kildare, Ireland
| | | | - Mitchell Byrne
- Faculty of Health, Charles Darwin University, Darwin, NT, Australia
| | - David Mitchell
- Faculty of Health, Charles Darwin University, Darwin, NT, Australia
- Department of Health, Office of the Chief Psychiatrist, Darwin, NT, Australia
| | - Carol Keane
- Faculty of Health, Charles Darwin University, Darwin, NT, Australia
| | - Mark Shevlin
- School of Psychology, Ulster University, Coleraine, Northern Ireland
| | - Grace Ho
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong, China SAR
| | | | | | - Xianliang Liu
- Faculty of Health, Charles Darwin University, Darwin, NT, Australia
| | - Jianxia Zhai
- STEM College, RMIT University, Melbourne, VIC, Australia
| | - Dominic Murphy
- Department of Research, Combat Stress, Leatherhead, UK
- King's Centre for Military Health Research, King's College London, London, UK
| | - Thanos Karatzias
- School of Health & Social Care, Edinburgh Napier University, Edinburgh, UK
- Rivers Centre for Traumatic Stress, NHS Lothian, Edinburgh, UK
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4
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McElroy E, Hyland P, Shevlin M, Karatzias T, Vallières F, Ben-Ezra M, Vang ML, Lorberg B, Martsenkovskyi D. Change in child mental health during the Ukraine war: evidence from a large sample of parents. Eur Child Adolesc Psychiatry 2024; 33:1495-1502. [PMID: 37421462 PMCID: PMC11098962 DOI: 10.1007/s00787-023-02255-z] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2022] [Accepted: 06/23/2023] [Indexed: 07/10/2023]
Abstract
The ongoing war in Ukraine is expected to negatively impact the mental health of the country's population. This study aims to provide a preliminary estimate of the degree of change in the mental health problems of Ukrainian children following Russia's invasion in February 2022, and to identify the sociodemographic and war-related risk factors associated with these changes. A nationwide, opportunistic sample of 1238 parents reported on a single randomly chosen child within their household as part of The Mental Health of Parents and Children in Ukraine Study. Data were collected between July 15th and September 5th, 2022. Participants completed modified versions of the Pediatric Symptom Checklist (PSC-17) which was adapted to capture change in the frequency of symptoms since the beginning of the war. Parents reported increases across all 17 indicators of internalizing, externalizing, and attention problems of the PSC-17. Increased problems were most pronounced within the internalizing domain, with 35% of parents reporting that their child worried more since the beginning of the war. A number of individual, parental, and war-related factors were associated with increases across the three domains. Exposure to war trauma, pre-existing mental health problems, and child age were among the strongest predictors of change. This survey provides preliminary evidence that the Russian war on Ukraine has led to an increase in common mental health problems among children in the general population. Further research is required to determine the extent and sequela of this increase, and to develop intervention strategies for those most in need.
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Affiliation(s)
- Eoin McElroy
- School of Psychology, Ulster University, Derry, Northern Ireland, UK.
| | - Philip Hyland
- Department of Psychology, Maynooth University, Kildare, Ireland
| | - Mark Shevlin
- School of Psychology, Ulster University, Derry, Northern Ireland, UK
| | - Thanos Karatzias
- School of Health and Social Care, Edinburgh Napier University, Edinburgh, Scotland, UK
| | | | | | - Maria Louison Vang
- Centre for Psychotraumatology, University of Southern Denmark, Odense, Denmark
| | - Boris Lorberg
- Department of Psychiatry, University of Massachusetts Chan Medical School, Worcester, MA, USA
| | - Dmytro Martsenkovskyi
- Department of Psychiatry and Narcology, Bogomolets National Medical University, Kyiv, Ukraine
- Institute of Psychiatry, Forensic Psychiatric Examination and Drug Monitoring, Ministry of Health of Ukraine, Kyiv, Ukraine
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Rawers C, Redican E, Alpay EH, McElroy E, Shevlin M. Multiple trauma exposure and psychopathology in Syrian refugees living in Turkey: A latent class analysis. Acta Psychol (Amst) 2024; 245:104220. [PMID: 38490133 DOI: 10.1016/j.actpsy.2024.104220] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2023] [Revised: 03/08/2024] [Accepted: 03/11/2024] [Indexed: 03/17/2024] Open
Abstract
BACKGROUND After the Syrian civil war, millions of Syrian refugees migrated to neighboring countries, with the majority settling in Turkey. The prevalence of mental disorders is notably higher among refugee populations. However, prior research on Syrian refugees have mostly used variable-centred approaches which have known limitations. Thus, the present study sought to examine the occurrence and co-occurrence of traumatic experiences among Syrian refugees living in Turkey using latent class analysis (LCA). Additionally, this study aimed to identify the associations between latent class membership and trauma-related psychopathology. METHODS Participants included 593 Syrian refugees living in Turkey. LCA was used to identify latent classes of trauma exposure. Demographic predictors of the latent classes were examined and associations with PTSD, CPTSD, depression and anxiety were also explored. RESULTS Three latent classes were identified based on trauma exposure; a "multiple traumas" class, "war and human suffering" class, and "low exposure, combat-exposed" class. Odds of PTSD, CPTSD, depression, or anxiety diagnosis did not differ significantly between classes, with the exception of the "multiple traumas" class who were more likely to meet the criteria for anxiety diagnosis compared to the "low exposure" class. LIMITATIONS Historic psychiatric symptoms or post-migration stressors could not be accounted for in this study, which may explain the lack of significant differences in most mental health outcomes by trauma exposure class. DISCUSSION The latent classes identified in this study correspond with previous research regarding trauma in Syrian refugees. However, this study largely failed to find significant differences in mental health diagnoses between classes. Future research should consider the effect of post-migration stressors in refugee populations, which may play a crucial role in mental health outcomes.
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Affiliation(s)
| | - Enya Redican
- Ulster University, School of Psychology, Coleraine, UK
| | | | - Eoin McElroy
- Ulster University, School of Psychology, Coleraine, UK
| | - Mark Shevlin
- Ulster University, School of Psychology, Coleraine, UK.
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6
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Redican E, Hyland P, Shevlin M, Martsenkovskyi D, Karatzias T, Ben-Ezra M. Prevalence and correlates of ICD-11 prolonged grief disorder among adults living in Ukraine during the war with Russia. Acta Psychiatr Scand 2024; 149:425-435. [PMID: 38491862 DOI: 10.1111/acps.13678] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Revised: 01/31/2024] [Accepted: 02/18/2024] [Indexed: 03/18/2024]
Abstract
BACKGROUND Although high rates of bereavement are evident in war-affected populations, no study has investigated the prevalence and correlates of probable ICD-11 prolonged grief disorder (PGD) under these circumstances. METHODS Participants were 2050 adults who participated in a nationwide survey exploring the effects of the Ukraine-Russia war on the daily lives and mental health of Ukrainian people. RESULTS Of the total sample, 87.7% (n = 1797) of people indicated a lifetime bereavement. In the full sample, 11.4% met the diagnostic requirements for probable ICD-11 PGD, and amongst those with a lifetime bereavement, the conditional rate of probable ICD-11 PGD was 13.0%. Significant risk factors of ICD-11 PGD included the recent loss of a loved one (6 months to a year ago), being most affected by a partner or spouse's death, loved one dying in the war, no recent contact with the deceased prior to their death, and meeting depression and anxiety diagnostic requirements. CONCLUSION The study reveals that a significant percentage of Ukrainian bereaved individuals have probable ICD-11 PGD, and identifying risk factors, particularly war-related losses, will aid in the development of intervention and prevention programs for bereaved adults.
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Affiliation(s)
- Enya Redican
- School of Psychology, Ulster University, Coleraine, UK
| | - Philip Hyland
- Department of Psychology, Maynooth University, Kildare, Ireland
| | - Mark Shevlin
- School of Psychology, Ulster University, Coleraine, UK
| | - Dmytro Martsenkovskyi
- Department of Psychiatry and Narcology, Bogomolets National Medical University, Kyiv, Ukraine
- SI "Institute of Psychiatry, Forensic Psychiatric Examination and Drug Monitoring of Ministry of Health of Ukraine", Kyiv, Ukraine
| | - Thanos Karatzias
- School of Health & Social Care, Edinburgh Napier University, Edinburgh, UK
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Karatzias T, Shevlin M, Cloitre M, Busuttil W, Graham K, Hendrikx L, Hyland P, Biscoe N, Murphy D. Enhanced Skills Training in Affective and Interpersonal Regulation versus Treatment as Usual for ICD-11 Complex PTSD: A Pilot Randomised Controlled Trial (The RESTORE Trial). Psychother Psychosom 2024:1-13. [PMID: 38688242 DOI: 10.1159/000538428] [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] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Accepted: 03/16/2024] [Indexed: 05/02/2024]
Abstract
INTRODUCTION Complex PTSD (CPTSD) is a relatively new condition in ICD-11. This pilot randomised controlled trial aimed to compare a four-module intervention developed to target all symptoms of ICD-11 CPTSD, namely Enhanced Skills in Affective and Interpersonal Regulation (ESTAIR) with treatment as usual (TAU). The purpose of the study was to assess feasibility, safety, acceptability, and preliminary outcomes at the end of treatment and 3-month follow-up. METHODS A total of N = 56 eligible veterans with CPTSD were randomised to either ESTAIR (n = 28) or TAU (n = 28). Linear mixed models were conducted to assess CPTSD severity, the primary outcome, as measured by the International Trauma Questionnaire (ITQ). RESULTS Treatment dropout in ESTAIR and TAU was low and equivalent (18% vs. 11%; χ2 (1) = 1.19, p = 0.275), and study retention was high, supporting the feasibility of the study. No serious adverse effects and very few adverse effects occurred, none of which were deemed related to the study. ESTAIR provided significantly greater reduction in CPTSD severity across time for ITQ PTSD (p < 0.001) and DSO (p < 0.001) symptoms. CPTSD pre-to-post effect sizes for ESTAIR were large (PTSD d = 1.78; DSO d = 2.00). Remission of probable CPTSD diagnosis at post-treatment was substantially greater in ESTAIR compared to TAU with only 13.6% versus 84% (p < 0.001) retaining the diagnosis. CONCLUSION A trial of ESTAIR versus TAU for the treatment of ICD-11 CPTSD indicates the potential efficacy of ESTAIR as well as its feasibility, safety, and acceptability.
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Affiliation(s)
- Thanos Karatzias
- School of Health and Social Care, Edinburgh Napier University, Edinburgh, UK
- NHS Lothian Rivers Centre for Traumatic Stress, Edinburgh, UK
| | - Mark Shevlin
- School of Psychology, Ulster University, Northern Ireland, UK
| | - Marylène Cloitre
- National Center for PTSD Dissemination and Training Division, VA Palo Alto Health Care System, Palo Alto, California, USA
- Department of Psychiatry and Behavioural Sciences, Stanford University, Stanford, California, USA
| | | | | | | | - Philip Hyland
- Department of Psychology, Maynooth University, Kildare, Ireland
| | | | - Dominic Murphy
- National Center for PTSD Dissemination and Training Division, VA Palo Alto Health Care System, Palo Alto, California, USA
- King's Centre for Military Research, Kings College London, London, UK
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8
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Ho GWK, Chan KL, Karatzias T, Hyland P, Fung HW, Shevlin M. Prevalence and validity of ICD-11 posttraumatic stress disorder (PTSD) and complex PTSD: A population-based survey of Hong Kong adults. Asian J Psychiatr 2024; 96:104045. [PMID: 38643682 DOI: 10.1016/j.ajp.2024.104045] [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] [Received: 07/05/2023] [Revised: 03/29/2024] [Accepted: 04/06/2024] [Indexed: 04/23/2024]
Abstract
The present study aimed to report the prevalence of ICD-11 posttraumatic stress disorder (PTSD) and complex PTSD (CPTSD) in the general adult Hong Kong population, and examine the validity of the Chinese International Trauma Questionnaire (ITQ). This descriptive cross-sectional population-based telephone survey included a representative sample of 1070 non-institutionalized permanent Hong Kong residents ages 18-64 years. Participants provided responses to the Chinese version of the ITQ, and measures of adverse childhood experiences (ACEs), depression, anxiety, and stress. Based on the diagnostic algorithm of the ITQ, 5.9% of the sample screened positive for either CPTSD or PTSD, with CPTSD (4.2%) being more common that PTSD (1.7%). Results of the confirmatory factor analysis indicated the first-order correlated 6-factor model to be the best fitting solution. Symptom cluster summed scores were all positively and significantly correlated with all criterion variables. This investigation established the prevalence rates of ICD-11 PTSD and CPTSD using a general adult population sample in Hong Kong. The Chinese ITQ demonstrated sound factorial validity and concurrent validity. Future research can further characterize ICD-11 PTSD and CPTSD in subgroups using the Chinese ITQ.
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Affiliation(s)
- Grace W K Ho
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong, SAR China.
| | - Ko Ling Chan
- Department of Applied Social Sciences, The Hong Kong Polytechnic University, Hong Kong, SAR China
| | - Thanos Karatzias
- School of Health & Social Care, Edinburgh Napier University, United Kingdom
| | - Philip Hyland
- Department of Psychology, Maynooth University, Ireland
| | - Hong Wang Fung
- Department of Social Work, Hong Kong Baptist University, Hong Kong, SAR China
| | - Mark Shevlin
- School of Psychology, Ulster University, United Kingdom
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Martsenkovskyi D, Shevlin M, Ben-Ezra M, Bondjers K, Fox R, Karatzias T, Martsenkovska I, Martsenkovsky I, Pfeiffer E, Sachser C, Vallières F, Hyland P. Mental health in Ukraine in 2023. Eur Psychiatry 2024; 67:e27. [PMID: 38533632 PMCID: PMC10988158 DOI: 10.1192/j.eurpsy.2024.12] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2023] [Revised: 01/17/2024] [Accepted: 01/21/2024] [Indexed: 03/28/2024] Open
Abstract
BACKGROUND Very little is known about the mental health of the adult population of Ukraine following Russia's full-scale invasion in February 2022. In this study, we estimated the prevalence of seven mental health disorders, the proportion of adults screening positive for any disorder, and the sociodemographic factors associated with meeting requirements for each and any disorder. METHODS A non-probability quota sample (N = 2,050) of adults living in Ukraine in September 2023 was collected online. Participants completed self-report questionnaires of the seven mental health disorders. Logistic regression was used to determine the predictors of the different disorders. RESULTS Prevalence estimates ranged from 1.5% (cannabis use disorder) to 15.2% (generalized anxiety disorder), and 36.3% screened positive for any of the seven disorders. Females were significantly more likely than males (39.0% vs. 33.8%) to screen positive for any disorder. Disruption to life due to Russia's 2014 invasion of Ukraine, greater financial worries, and having fewer positive childhood experiences were consistent risk factors for different mental health disorders and for any or multiple disorders. CONCLUSION Our findings show that approximately one in three adults living in Ukraine report problems consistent with meeting diagnostic requirements for a mental health disorder 18 months after Russia's full-scale invasion. Ukraine's mental healthcare system has been severely compromised by the loss of infrastructure and human capital due to the war. These findings may help to identify those most vulnerable so that limited resources can be used most effectively.
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Affiliation(s)
- Dmytro Martsenkovskyi
- Department of Psychiatry and Narcology, Bogomolets National Medical University, Kyiv, Ukraine
- SI Institute of Psychiatry, Forensic Psychiatric Examination and Drug Monitoring of Ministry of Health of Ukraine, Kyiv, Ukraine
| | - Mark Shevlin
- School of Psychology, Ulster University, Derry, Northern Ireland
| | | | - Kristina Bondjers
- Norwegian Centre for Violence and Traumatic Stress Studies, Oslo, Norway
| | - Robert Fox
- School of Business, National College of Ireland, Dublin, Ireland
| | - Thanos Karatzias
- School of Health and Social Care, Edinburgh Napier University, Scotland
| | - Inna Martsenkovska
- SI Institute of Psychiatry, Forensic Psychiatric Examination and Drug Monitoring of Ministry of Health of Ukraine, Kyiv, Ukraine
| | - Igor Martsenkovsky
- SI Institute of Psychiatry, Forensic Psychiatric Examination and Drug Monitoring of Ministry of Health of Ukraine, Kyiv, Ukraine
| | - Elisa Pfeiffer
- Department of Child and Adolescent Psychiatry and Psychotherapy, Ulm University, Ulm, Germany
| | - Cedric Sachser
- Department of Child and Adolescent Psychiatry and Psychotherapy, Ulm University, Ulm, Germany
| | - Frédérique Vallières
- Trinity Centre for Global Health, University of Dublin, Trinity College, Dublin, Ireland
| | - Philip Hyland
- Department of Psychology, Maynooth University, Kildare, Ireland
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10
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Peinado V, Valiente C, Contreras A, Trucharte A, Butter S, Murphy J, Shevlin M. ICD-11 prolonged grief disorder: Prevalence, predictors, and co-occurrence in a large representative sample. Int J Psychol 2024; 59:86-95. [PMID: 37828650 DOI: 10.1002/ijop.12951] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Accepted: 09/19/2023] [Indexed: 10/14/2023]
Abstract
The International Classification of Diseases has recently defined Prolonged Grief Disorder (PGD) with symptoms such as longing, worry, and intense emotional pain that exceed sociocultural norms more than 6 months after the loss. This study aims to (a) estimate the prevalence of this new diagnostic category, (b) identify its sociodemographic and loss-related predictors, and (c) assess the co-occurrence of PGD with other psychological disorders and substance abuse. A large representative sample of Spanish adults (N = 1498) participated. Several multivariate binary logistic regression and multivariate logistic regression models were used. Results showed a 9.95% prevalence in the total sample. Catholic beliefs were a positive predictor, while higher income and more time since loss significantly decreased the odds of PGD. PGD significantly increased the likelihood of anxiety, depression, somatisation, post-traumatic stress disorder, loneliness and substance use. Our study contributes to assessing the multicultural PGD validity, as our results from a large representative sample are comparable to those in other countries with the PGDS. Our findings have direct implications for the assessment and treatment of bereavement, identifying for practitioners variables that make individuals more vulnerable to PGD. Results highlighted the high co-occurrence of PGD with other psychological illnesses and increased drug use.
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Affiliation(s)
- Vanesa Peinado
- Facultad de Psicología Clínica, Universidad Complutense de Madrid, Madrid, Spain
| | - Carmen Valiente
- Facultad de Psicología Clínica, Universidad Complutense de Madrid, Madrid, Spain
| | - Alba Contreras
- Departamento de Psicología, Facultad de Medicina, Universidad Católica San Antonio de Murcia, Murcia, Spain
| | - Almudena Trucharte
- Departamento de Psicología, Facultad de Salud, Universidad Camilo José Cela, Madrid, Spain
| | - Sarah Butter
- School of Psychology, Ulster University, Coleraine, UK
| | - Jamie Murphy
- School of Psychology, Ulster University, Coleraine, UK
| | - Mark Shevlin
- School of Psychology, Ulster University, Coleraine, UK
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11
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Contreras A, Butter S, Granziol U, Panzeri A, Peinado V, Trucharte A, Zavlis O, Valiente C, Vázquez C, Murphy J, Bertamini M, Shevlin M, Hartman TK, Bruno G, Mignemi G, Spoto A, Vidotto G, Bentall RP. The network structure of psychopathological and resilient responses to the pandemic: A multicountry general population study of depression and anxiety. J Trauma Stress 2024; 37:126-140. [PMID: 37957806 DOI: 10.1002/jts.22988] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2023] [Revised: 09/22/2023] [Accepted: 10/17/2023] [Indexed: 11/15/2023]
Abstract
Commonly identified patterns of psychological distress in response to adverse events are characterized by resilience (i.e., little to no distress), delayed (i.e., distress that increases over time), recovery (i.e., distress followed by a gradual decrease over time), and sustained (i.e., distress remaining stable over time). This study aimed to examine these response patterns during the COVID-19 pandemic. Anxiety and depressive symptom data collected across four European countries over the first year of the pandemic were analyzed (N = 3,594). Participants were first categorized into groups based on the four described patterns. Network connectivity and symptom clustering were then estimated for each group and compared. Two thirds (63.6%) of the sample displayed a resilience pattern. The sustained distress network (16.3%) showed higher connectivity than the recovery network (10.0%) group, p = .031; however, the resilient network showed higher connectivity than the delayed network (10.1%) group, p = .016. Regarding symptom clustering, more clusters emerged in the recovery network (i.e., three) than the sustained network (i.e., two). These results replicate findings that resilience was the most common mental health pattern over the first pandemic year. Moreover, they suggest that high network connectivity may be indicative of a stable mental health response over time, whereas fewer clusters may be indicative of a sustained distress pattern. Although exploratory, the network perspective provides a useful tool for examining the complexity of psychological responses to adverse events and, if replicated, could be useful in identifying indicators of protection against or vulnerability to future psychological distress.
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Affiliation(s)
- Alba Contreras
- Department of Biological and Health Psychology, Area of Personality, Assessment and Clinical intervention, University Autonoma of Madrid, Madrid, Spain
- Department of Personality Assessment and Clinical Psychology, University Complutense of Madrid, Madrid, Spain
| | - Sarah Butter
- School of Psychology, Ulster University, Coleraine, Northern Ireland, UK
| | - Umberto Granziol
- Department of General Psychology, University of Padua, Padua, Italy
| | - Anna Panzeri
- Department of General Psychology, University of Padua, Padua, Italy
| | - Vanesa Peinado
- Department of Personality Assessment and Clinical Psychology, University Complutense of Madrid, Madrid, Spain
| | - Almudena Trucharte
- Department of Personality Assessment and Clinical Psychology, University Complutense of Madrid, Madrid, Spain
- Department of Psychology, Faculty of Health, Camilo Jose Cela University, Madrid, Spain
| | - Orestis Zavlis
- Clinical Psychology Unit, Department of Psychology, University of Sheffield, Sheffield, UK
| | - Carmen Valiente
- Department of Personality Assessment and Clinical Psychology, University Complutense of Madrid, Madrid, Spain
| | - Carmelo Vázquez
- Department of Personality Assessment and Clinical Psychology, University Complutense of Madrid, Madrid, Spain
| | - Jamie Murphy
- School of Psychology, Ulster University, Coleraine, Northern Ireland, UK
| | - Marco Bertamini
- Faculty of Health & Life Sciences, University of Liverpool, Liverpool, UK
| | - Mark Shevlin
- School of Psychology, Ulster University, Coleraine, Northern Ireland, UK
| | - Todd K Hartman
- School of Social Science, University of Manchester, Manchester, UK
| | - Giovanni Bruno
- Department of General Psychology, University of Padua, Padua, Italy
| | - Giuseppe Mignemi
- Department of General Psychology, University of Padua, Padua, Italy
| | - Andrea Spoto
- Department of General Psychology, University of Padua, Padua, Italy
| | - Giulio Vidotto
- Department of General Psychology, University of Padua, Padua, Italy
| | - Richard P Bentall
- Clinical Psychology Unit, Department of Psychology, University of Sheffield, Sheffield, UK
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Hyland P, Redican E, Karatzias T, Shevlin M. The International Grief Questionnaire (IGQ): A new measure of ICD-11 prolonged grief disorder. J Trauma Stress 2024; 37:141-153. [PMID: 37919835 DOI: 10.1002/jts.22986] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Revised: 10/03/2023] [Accepted: 10/18/2023] [Indexed: 11/04/2023]
Abstract
Prolonged grief disorder (PGD) is included in the 11th version of the International Statistical Classification of Diseases and Related Health Problems (ICD-11). This study sought to test the validity and reliability of a new brief measure to screen for ICD-11 PGD-the International Grief Questionnaire (IGQ). The psychometric properties of the IGQ were tested using data collected from two bereaved samples of adults from the United Kingdom (n = 1,012) and Ireland (n = 1,011). Confirmatory factor analysis demonstrated that a correlated two-factor model best captured the latent dimensionality of the IGQ in both samples. Estimates of internal reliability were high, whereas the convergent and concurrent validity of the scale were supported through strong associations with external measures. Measurement invariance and differential item functioning testing showed no statistically significant difference in the latent structure of the IGQ nor the functioning of the IGQ items by age, sex, and nationality. For participants who were bereaved for more than 6 months, the rates of probable PGD derived from the IGQ were 10.9% and 15.3% for the Irish and U.K. samples, respectively. The IGQ is a brief, easy-to-use, self-report screening measure that captures all diagnostic criteria of PGD set forth in the ICD-11. Findings from this study provide initial support for the validity, measurement invariance, and reliability of the IGQ among two national samples.
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Affiliation(s)
- Philip Hyland
- Department of Psychology, Maynooth University, Kildare, Ireland
| | - Enya Redican
- School of Psychology, Ulster University, Coleraine, Northern Ireland, UK
| | - Thanos Karatzias
- School of Health and Social Care, Napier University, Edinburgh, Scotland, UK
| | - Mark Shevlin
- School of Psychology, Ulster University, Coleraine, Northern Ireland, UK
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Hyland P, Brewin CR, Cloitre M, Karatzias T, Shevlin M. Responding to concerns related to the measurement of ICD-11 complex posttraumatic stress disorder using the International Trauma Questionnaire. Child Abuse Negl 2024; 147:106563. [PMID: 38007852 DOI: 10.1016/j.chiabu.2023.106563] [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] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Revised: 11/09/2023] [Accepted: 11/15/2023] [Indexed: 11/28/2023]
Abstract
BACKGROUND A recent study in this journal by Frewen et al. (2023) provided a critical analysis of the most widely used measure of ICD-11 Complex Posttraumatic Stress Disorder (CPTSD), the International Trauma Questionnaire (ITQ). The article was a thoughtful review and gave voice to several widely held concerns about the nature of CPTSD as it is represented in ICD-11 and measured by the ITQ. The primary concern expressed by Frewen et al. was that the symptom profile of ICD-11 CPTSD, as represented in the ITQ, is too simple and fails to provide adequate coverage of the construct. OBJECTIVE Despite its quality, the article included several misunderstandings about the nature of ICD-11 CPTSD, and the function of the ITQ, that we wish to clarify. PARTICIPANTS Not applicable. SETTING Not applicable. RESULTS In this article, we provide a description of what ICD-11 PTSD and CPTSD are, a review of the process that led to their inclusion in ICD-11, how the ITQ was developed and refined to measure these constructs. We then provide responses to several of the most important concerns raised by Frewen et al. CONCLUSIONS: We highlight the clinical utility of the ICD-11 descriptions of PTSD and CPTSD and discuss how the ITQ can be used as part of a suite of clinical assessments to accurately describe and understand common experiences of psychological distress that often result from exposure to traumatic life events.
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Affiliation(s)
- Philip Hyland
- Department of Psychology, Maynooth University, Kildare, Ireland.
| | - Chris R Brewin
- Division of Psychology and Language Sciences, University College London, London, England, United Kingdom
| | - Marylène Cloitre
- National Center for PTSD Dissemination and Training Division, VA Palo Alto Health Care System, Palo Alto, CA, United States; Department of Psychiatry and Behavioural Sciences, Stanford University, Stanford, CA, United States
| | - Thanos Karatzias
- Edinburgh Napier University, School of Health & Social Care, Edinburgh, Scotland, United Kingdom
| | - Mark Shevlin
- School of Psychology, Ulster University, Derry, Northern Ireland, United Kingdom
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14
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Hyland P, Hamer R, Fox R, Vallières F, Karatzias T, Shevlin M, Cloitre M. Is Dissociation a Fundamental Component of ICD-11 Complex Posttraumatic Stress Disorder? J Trauma Dissociation 2024; 25:45-61. [PMID: 37401797 DOI: 10.1080/15299732.2023.2231928] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Accepted: 05/09/2023] [Indexed: 07/05/2023]
Abstract
ICD-11 Complex Posttraumatic Stress Disorder (CPTSD) is a disorder of six symptom clusters including reexperiencing, avoidance, sense of threat, affective dysregulation, negative self-concept, and disturbed relationships. Unlike earlier descriptions of complex PTSD, ICD-11 CPTSD does not list dissociation as a unique symptom cluster. We tested whether the ICD-11 CPTSD symptoms can exist independently of dissociation in a nationally representative sample of adults (N = 1,020) who completed self-report measures. Latent class analysis was used to identify unique subsets of people with distinctive symptom profiles. The best fitting model contained four classes including a "low symptoms" class (48.9%), a "PTSD" class (14.7%), a "CPTSD" class (26.5%), and a "CPTSD + Dissociation" class (10.0%). These classes were related to specific adverse childhood experiences, notably experiences of emotional and physical neglect. The "PTSD," "CPTSD," and "CPTSD + Dissociation" classes were associated with a host of poor health outcomes, however, the "CPTSD + Dissociation" class had the poorest mental health and highest levels of functional impairment. Findings suggest that ICD-11 CPTSD symptoms can occur without corresponding dissociative experiences, however, when CPTSD symptoms and dissociative experiences occur together, health outcomes appear to be more severe.
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Affiliation(s)
- Philip Hyland
- Department of Psychology, Maynooth University, Kildare, Ireland
| | - Ruby Hamer
- Department of Medicine, Monash University, Melbourne, Australia
| | - Robert Fox
- School of Business, National College of Ireland, Dublin, Ireland
| | | | - Thanos Karatzias
- School of Health & Social Care, Edinburgh Napier University, Edinburgh, UK
- NHS Lothian Rivers Centre for Traumatic Stress, Edinburgh, UK
| | - Mark Shevlin
- School of Psychology, Ulster University, Coleraine, Northern, Ireland
| | - Marylene Cloitre
- National Center for PTSD Dissemination and Training Division, VA Palo Alto Health Care System, Palo Alto, California, USA
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, California, USA
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15
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Gibson-Miller J, Zavlis O, Hartman TK, Bennett KM, Butter S, Levita L, Martinez AP, Mason L, McBride O, McKay R, Murphy J, Shevlin M, Stocks TVA, Bentall RP. A network approach to understanding social distancing behaviour during the first UK lockdown of the COVID-19 pandemic. Psychol Health 2024; 39:109-127. [PMID: 35345961 DOI: 10.1080/08870446.2022.2057497] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2021] [Accepted: 03/17/2022] [Indexed: 10/18/2022]
Abstract
OBJECTIVE Given the highly infectious nature of COVID-19, social distancing practices are key in stemming the spread of the virus. We aimed to assess the complex interplay among psychological factors, socio-demographic characteristics and social distancing behaviours within the framework of the widely used Capability, Opportunity, Motivation-Behaviour (COM-B) model. DESIGN The present research employed network psychometrics on data collected during the first UK lockdown in April 2020 as part of the COVID-19 Psychological Research Consortium (C19PRC) Study. Using a network approach, we examined the predictions of psychological and demographic variables onto social distancing practices at two levels of analysis: macro and micro. RESULTS Our findings revealed several factors that influenced social distancing behaviour during the first UK lockdown. The COM-B model was successful in predicting particular aspects of social-distancing via the influence of psychological capability and motivation at the macro-and micro-levels, respectively. Notably, demographic variables, such as education, income, and age, were directly and uniquely predictive of certain social distancing behaviours. CONCLUSION Our findings reveal psychological factors that are key predictors of social distancing behaviour and also illustrate how demographic variables directly influence such behaviour. Our research has implications for the design of empirically-driven interventions to promote adherence to social distancing practices in this and future pandemics. Supplemental data for this article is available online at.
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Affiliation(s)
| | - Orestis Zavlis
- Department of Psychology, University of Sheffield, Sheffield, UK
| | | | | | - Sarah Butter
- Department of Psychology, University of Sheffield, Sheffield, UK
| | - Liat Levita
- Department of Psychology, University of Sheffield, Sheffield, UK
| | - Anton P Martinez
- Department of Psychology, University of Sheffield, Sheffield, UK
| | | | | | - Ryan McKay
- Royal Holloway, University of London, Egham, UK
| | | | | | | | - Richard P Bentall
- Department of Psychology, University of Sheffield, Sheffield, UK
- University of Liverpool, Liverpool, UK
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16
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Fernández-Fillol C, Hidalgo-Ruzzante N, Perez-Garcia M, Hyland P, Shevlin M, Karatzias T. The role of resilience in the relationship between intimate partner violence severity and ICD-11 CPTSD severity. Eur J Psychotraumatol 2023; 15:2285671. [PMID: 38156874 PMCID: PMC10763906 DOI: 10.1080/20008066.2023.2285671] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Accepted: 10/19/2023] [Indexed: 01/03/2024] Open
Abstract
Background: Resilience is a modulating factor in the development of PTSD and CPTSD after exposure to traumatic events. However, the relationship between resilience and ICD-11 CPTSD is not adequately understood in survivors of intimate partner violence (IPV).Objective: The aim of this study is to determine whether resilience has a mediating role in the relationship between severity of violence and severity of CPTSD symptoms.Method: A sample of 202 women IPV survivors completed self-rated questionnaires to assess CPTSD, severity of violence and resilience.Results: Mediation analyses indicated that there was a direct relationship between the severity of violence and the severity of CPTSD symptoms (β = .113, p < .001) and that there was a significantly inverse relationship between levels of resilience and the severity of CPTSD symptoms (β = -.248, p < .001). At the same time, there was no significant relationship between the severity of violence and resilience (β = -.061, p = .254).Conclusions: These findings suggest that resilience does not mediate the relationship between violence severity and CPTSD severity. Directions for future research are discussed.
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Affiliation(s)
- Carmen Fernández-Fillol
- Department of Health Sciences, Valencian International University, Valencia, Spain
- Faculty of Health Sciences, Isabel I University, Burgos, Spain
- Mind, Brain and Behavior Research Center (CIMCYC), University of Granada, Granada, Spain
| | - Natalia Hidalgo-Ruzzante
- Mind, Brain and Behavior Research Center (CIMCYC), University of Granada, Granada, Spain
- Department of Developmental and Educational Psychology, University of Granada, Granada, Spain
- Faculty of Education, Campus de Cartuja, Granada, Spain
| | - Miguel Perez-Garcia
- Mind, Brain and Behavior Research Center (CIMCYC), University of Granada, Granada, Spain
- Department of Personality, Assessment and Psychological Treatment, University of Granada, Granada, Spain
- Faculty of Psychology, Campus Universitario de Cartuja, Granada, Spain
| | - Philip Hyland
- Department of Psychology, Maynooth University, Kildare, Ireland
- Centre for Global Health, Trinity College Dublin, Dublin, Ireland
- Education House, Maynooth University, Kildare, Ireland
| | - Mark Shevlin
- School of Psychology, Ulster University, Londonderry, Northern Ireland
| | - Thanos Karatzias
- School of Health & Social Care, Edinburgh Napier University, Edinburgh, UK
- NHS Lothian, Rivers Centre for Traumatic Stress, Edinburgh, UK
- School of Health & Social Care, Edinburgh Napier University, Edinburgh, UK
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17
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Redican E, Vang ML, Komischke-Konnerup K, Elklit A, Shevlin M, O'Connor M. Operationalization, implications and correlates of the cultural deviance criterion for ICD-11 and DSM-5 prolonged grief disorder. Death Stud 2023:1-12. [PMID: 38147040 DOI: 10.1080/07481187.2023.2297061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/27/2023]
Abstract
Prolonged Grief Disorder (PGD) is included in ICD-11 and DSM-5-TR and includes a requirement of cultural deviance. This study examined endorsement rates and factors associated with endorsement of this criterion among Danish bereaved spouses (n = 425) and their adult children (n = 159) four years post-loss. In total, 7.5% (n = 44) participants endorsed this criterion. Both including and excluding the criterion, the prevalence rates for probable DSM-5-TR PGD were 1.4% (n = 8) and 1.7% (n = 10), respectively and for probable ICD-11 PGD were 1.4% (n = 8) and 2.2% (n = 13), respectively. Age and gender of the deceased, age of the bereaved, greater grief severity, and comorbid psychopathology were positively associated with endorsement of the criterion. Findings demonstrate low endorsement of the cultural deviation criterion, that its inclusion excludes several potential PGD cases, and unanticipated associations with several factors raise questions about the criterion's validity.
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Affiliation(s)
- E Redican
- Department of Psychology, Ulster University, Coleraine, UK
| | - M L Vang
- National Centre for Psychotraumatology, Department of Psychology, University of Southern, Odense, Denmark
- Unit for Bereavement Research, Department of Psychology and Behavioral Sciences, Aarhus University, Aarhus, Denmark
| | - K Komischke-Konnerup
- Unit for Bereavement Research, Department of Psychology and Behavioral Sciences, Aarhus University, Aarhus, Denmark
| | - A Elklit
- National Centre for Psychotraumatology, Department of Psychology, University of Southern, Odense, Denmark
| | - M Shevlin
- Department of Psychology, Ulster University, Coleraine, UK
| | - M O'Connor
- Unit for Bereavement Research, Department of Psychology and Behavioral Sciences, Aarhus University, Aarhus, Denmark
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18
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Breslin G, Hillyard M, Brick N, Shannon S, McKay-Redmond B, Shevlin M, McConnell B. Predicting school uptake of The Daily Mile in Northern Ireland- a data linkage study with School Census Data and Multiple Deprivation Measures. PLoS One 2023; 18:e0294648. [PMID: 38096181 PMCID: PMC10721005 DOI: 10.1371/journal.pone.0294648] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Accepted: 11/05/2023] [Indexed: 12/17/2023] Open
Abstract
BACKGROUND Participating in physical activity benefits health, yet a majority of children remain inactive. The Daily Mile™ (TDM) originated in Scotland in 2012 with the aim of increasing primary school children's physical fitness. Despite being a practically feasible and popular initiative, it remains unclear the extent to which schools implement TDM, and whether TDM core principles are adhered to (i.e., run or jog at least 3-days per week). In Northern Ireland it is unknown how many schools regularly participate in TDM, and whether there is an association between TDM participation with school type, school location, size, total number of children attending the school, school deprivation level, and/or motivation as measured by the COM-B model (Capabilities, Opportunities, Motivation model of behaviour). Therefore, this study aimed to quantify the uptake of TDM in Northern Ireland, assess whether schools are following the core principles, and analyse if there is an association between aforesaid demographic factors and TDM participation. METHODS An online cross-sectional survey was sent to all primary and special education schools in Northern Ireland with the support of the Education Authority for Northern Ireland and the Public Health Agency for Northern Ireland. The survey was completed by the school principal or teacher, and was available from 31st August until 16th December 2022. Survey results were linked with the 2021/2022 Northern Ireland School Census Data and Northern Ireland Multiple Deprivation Measure 2017. Quantitative and qualitative questions were included in the survey to assess participation and implementation of TDM. RESULTS The survey received 609 school responses. After data cleaning, and removal of duplicates from schools a sample of 358 primary schools (45%) and 19 special education schools (47.5%) was analysed. Over half (54.7%) of primary schools and 36.8% of special education schools reported taking part in TDM. More special education needs schools reported taking part in their own version of an 'active mile' rather than TDM formally, and qualitative findings showed TDM was not perceived as appropriate for many children in special educational settings. There was wide variation in adherence to TDM core principles. A multivariate binary logistic regression model was fitted to the data, but it was not statistically significant (χ2(17) = 22.689, p = .160). However, univariate effects showed that increasing levels on COM-B (Capability) was associated with increased likelihood of TDM participation (OR = 2.506), and Catholic Maintained schools were almost twice as likely as Controlled schools to be delivering TDM (OR = 1.919). There was no association found between deprivation and TDM uptake. CONCLUSION Encouragingly over 50% of schools in Northern Ireland reported taking part in TDM. However, despite being a low-cost and practically feasible physical activity initiative, further intervention work with sound research methodology is needed to promote adherence to TDM core principles to maximise benefits to children's health. Furthermore, concerted efforts are required to adjust TDM so that it is inclusive for all educational settings, and children's abilities.
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Affiliation(s)
- Gavin Breslin
- School of Psychology, Queens University Belfast, Belfast, Northern Ireland
| | - Medbh Hillyard
- Bamford Centre for Mental Health and Wellbeing, School of Psychology, Ulster University, Coleraine, Northern Ireland
- School of Psychology, Ulster University, Coleraine, Northern Ireland
| | - Noel Brick
- School of Psychology, Ulster University, Coleraine, Northern Ireland
| | - Stephen Shannon
- Bamford Centre for Mental Health and Wellbeing, School of Psychology, Ulster University, Coleraine, Northern Ireland
- School of Psychology, Ulster University, Coleraine, Northern Ireland
- Sport and Exercise Sciences Research Institute, Ulster University, Belfast, Northern Ireland
| | - Brenda McKay-Redmond
- Early Childhood Studies Department, Stranmillis University College, Belfast, Northern Ireland
| | - Mark Shevlin
- School of Psychology, Ulster University, Coleraine, Northern Ireland
| | - Barbara McConnell
- Early Childhood Studies Department, Stranmillis University College, Belfast, Northern Ireland
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O'Connor M, Vang ML, Shevlin M, Elklit A, Komischke-Konnerup KB, Lundorff M, Bryant R. Development and validation of the Aarhus PGD scale for operationalizing ICD-11 and DSM-5-TR TR Prolonged Grief Disorder. J Affect Disord 2023; 342:201-209. [PMID: 37739019 DOI: 10.1016/j.jad.2023.09.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Revised: 09/11/2023] [Accepted: 09/17/2023] [Indexed: 09/24/2023]
Affiliation(s)
- Maja O'Connor
- Unit for Bereavement Research, Department of Psychology, Aarhus University, Denmark; The Danish National Center for Grief, Copenhagen, Denmark.
| | - Maria Louison Vang
- National Center for Psychotraumatology, University of Southern Denmark, Denmark; Dept. for Occupational and Environmental Health, Odense University Hospital, Denmark
| | - Mark Shevlin
- School of Psychology, Ulster University, Coleraine, Northern Ireland, United Kingdom of Great Britain and Northern Ireland
| | - Ask Elklit
- National Center for Psychotraumatology, University of Southern Denmark, Denmark
| | | | - Marie Lundorff
- Unit for Bereavement Research, Department of Psychology, Aarhus University, Denmark
| | - Richard Bryant
- School of Psychology, University of New South Wales, Sydney, Australia
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20
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Shevlin M, Redican E, Murphy J, Hyland P, Karatzias T. Testing the latent structure of ICD-11 prolonged grief disorder symptoms in the U.K. adult population: An exploratory structural equation modeling approach. J Trauma Stress 2023; 36:1077-1089. [PMID: 37703294 DOI: 10.1002/jts.22972] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Revised: 07/27/2023] [Accepted: 07/27/2023] [Indexed: 09/15/2023]
Abstract
The latent structure of ICD-11 prolonged grief disorder (PGD), as measured using the International Prolonged Grief Disorder Scale (IPGDS), was assessed in a large general population sample of bereaved adults from the United Kingdom. Data were derived from Wave 5 of the COVID-19 Psychological Research Consortium Study (C19PRC-UK). Exploratory structural equation modeling (ESEM) was used to assess the latent structure of the IPGDS. Identified factors were explored in relation to known correlates (i.e., gender, age of the bereaved, income, bereavement timeframe, age of the deceased) and functional impairment. Three factors-Loss, Emotional Numbing, and Emotional Reactivity-emerged in the best-fitting ESEM model, χ2 (92, N = 1,763) = 273.70, p < .001, CFI = .97, TLI = .96, RMSEA = .048, SRMR = .020. All factors were significantly associated with bereavement timeframe, βs = -.15--.20, and age of the deceased, βs = -.22--.31. Lower income predicted both Loss and Emotional Numbing; younger age of the bereaved predicted both Loss and Emotional Reactivity; and female gender was a unique predictor of Loss. Functional impairment was associated only with Emotional Numbing, β = .89. The findings highlight the multidimensional structure of PGD. However, the patterns of factor/cross-factor loadings observed in the present study indicate that a "simple" structure was not attainable. Associations between factors and covariates attest to the discriminant validity of the factors, and the association between Emotional Numbing and functional impairment may afford clinicians an opportunity to better understand and target the most disruptive features of grief.
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Affiliation(s)
- Mark Shevlin
- School of Psychology, Ulster University, Coleraine, Northern Ireland
| | - Enya Redican
- School of Psychology, Ulster University, Coleraine, Northern Ireland
| | - Jamie Murphy
- School of Psychology, Ulster University, Coleraine, Northern Ireland
| | - Philip Hyland
- Department of Psychology, Maynooth University, Maynooth, Ireland
| | - Thanos Karatzias
- School of Health and Social Care, Edinburgh Napier University, Edinburgh, United Kingdom
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21
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Levin Y, Bachem R, Hyland P, Vallières F, Shevlin M, Karatzias T, McElroy E, Vang ML, Lorberg B, Ben-Ezra M, Martsenkovskyi D. The association between daily life changes and anxiety among Ukrainians following the Russian invasion. Psychiatry Res 2023; 329:115530. [PMID: 37837809 DOI: 10.1016/j.psychres.2023.115530] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Revised: 09/07/2023] [Accepted: 10/05/2023] [Indexed: 10/16/2023]
Abstract
This study sought to explore the association between changes in daily life and war-related anxiety. In this study, we analyzed self-reported data from 2,004 Ukrainian adults, obtained through an opportunistic survey in the Ukraine. Our assessment focused on changes in everyday routines and generalized anxiety symptoms since the Russian invasion of Ukraine on the 24 February 2022. The data were collected between July-September 2022. Results show a significant dose-response connection between everyday routine changes and increased war-related anxiety. Not surprisingly, the ongoing Ukraine-Russia conflict is impacting the lives of Ukrainians. These changes are linked to heightened anxiety levels. Effective population-based crisis management should consider both war-related stressors and changes in daily life routines.
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Affiliation(s)
- Yafit Levin
- School of Education and School of Social Work, Ariel University, Ariel, Israel.
| | - Rahel Bachem
- Psychopathology and Clinical Intervention, Department of Psychology, University of Zurich, Zurich, Switzerland.
| | - Philip Hyland
- Department of Psychology, Maynooth University, Kildare, Ireland.
| | - Frédérique Vallières
- Trinity Centre for Global Health, University of Dublin, Trinity College, Dublin, Ireland.
| | - Mark Shevlin
- School of Psychology, Ulster University, Derry, Northern Ireland.
| | - Thanos Karatzias
- School of Health & Social Care, Edinburgh Napier University, Scotland.
| | - Eoin McElroy
- School of Psychology, Ulster University, Derry, Northern Ireland.
| | - Maria Louison Vang
- Centre for Psychotraumatology, University of Southern Denmark, Odense, Denmark.
| | - Boris Lorberg
- Department of Psychiatry, UMass Chan Medical School, Massachusetts, United States.
| | | | - Dmytro Martsenkovskyi
- Department of Psychiatry and Narcology, Bogomolets National Medical University, Kyiv, Ukraine; SI "Institute of Psychiatry, Forensic Psychiatric Examination and Drug Monitoring of Ministry of Health of Ukraine", Kyiv, Ukraine.
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22
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Hyland P, Vallières F, Shevlin M, Karatzias T, Ben-Ezra M, McElroy E, Vang ML, Lorberg B, Martsenkovskyi D. Psychological consequences of war in Ukraine: assessing changes in mental health among Ukrainian parents. Psychol Med 2023; 53:7466-7468. [PMID: 37016786 PMCID: PMC10719667 DOI: 10.1017/s0033291723000818] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Revised: 03/10/2023] [Accepted: 03/14/2023] [Indexed: 04/06/2023]
Affiliation(s)
- Philip Hyland
- Department of Psychology, Maynooth University, Kildare, Ireland
| | - Frédérique Vallières
- Trinity Centre for Global Health, Trinity College, University of Dublin, Dublin, Ireland
| | - Mark Shevlin
- School of Psychology, Ulster University, Derry, UK
| | - Thanos Karatzias
- School of Health & Social Care, Edinburgh Napier University, Edinburgh, UK
| | | | - Eoin McElroy
- School of Psychology, Ulster University, Derry, UK
| | - Maria Louison Vang
- Centre for Psychotraumatology, University of Southern Denmark, Odense, Denmark
| | - Boris Lorberg
- Department of Psychiatry, UMass Chan Medical School, Worcester, Massachusetts, USA
| | - Dmytro Martsenkovskyi
- Department of Psychiatry and Narcology, Bogomolets National Medical University, Kyiv, Ukraine
- SI ‘Institute of Psychiatry, Forensic Psychiatric Examination and Drug Monitoring of Ministry of Health of Ukraine’, Kyiv, Ukraine
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23
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Butter S, Shevlin M, McBride O, Bentall RP, Hyland P, Leavey G, Murphy J. Functioning, symptom expression and risk along the psychosis continuum. Psychol Med 2023; 53:7407-7417. [PMID: 37092866 PMCID: PMC10719677 DOI: 10.1017/s0033291723001046] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Revised: 03/25/2023] [Accepted: 03/31/2023] [Indexed: 04/25/2023]
Abstract
BACKGROUND The psychosis continuum implies that subclinical psychotic experiences (PEs) can be differentiated from clinically relevant expressions since they are not accompanied by a 'need for care'. METHODS Using data from Wave 2 of the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC; N = 34 653), the current study examined variation in functioning, symptomology and aetiological risk across the psychosis phenotype [i.e. variation from (i) no PEs, 'No PEs' to (ii) non-distressing PEs, 'PE-Experienced Only' to (iii) distressing PEs, 'PE-Impaired' to (iv) clinically defined psychotic disorder, 'Diagnosed']. RESULTS A graded trend was present such that, compared to those with no PEs, the Diagnosed group had the poorest functioning, followed by the PE-Impaired then PE-Experienced Only groups. In relation to symptom expression, the PE-Impaired group were more likely than the PE-Experienced Only and the Diagnosed groups to endorse most PEs. Predictors of group membership tended to vary quantitatively rather than qualitatively. Trauma, current mental health diagnoses (anxiety and depression) and drug use variables differentiated between all levels of the continuum, with the exception of the extreme end (PE-Impaired v. Diagnosed). Only a few variables distinguished groups at the upper end of the continuum: female sex, older age, unemployment, parental mental health hospitalisation and lower likelihood of having experienced physical assault. CONCLUSIONS The findings highlight the importance of continuum-based interpretations of the psychosis phenotype and afford valuable opportunities to consider if and how impairment, symptom expression and risk change along the continuum.
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Affiliation(s)
- Sarah Butter
- School of Psychology, Ulster University, Coleraine, Northern Ireland
- Bamford Centre for Mental Health & Wellbeing, Ulster University, Coleraine, Northern Ireland
| | - Mark Shevlin
- School of Psychology, Ulster University, Coleraine, Northern Ireland
| | - Orla McBride
- School of Psychology, Ulster University, Coleraine, Northern Ireland
| | - Richard P. Bentall
- Department of Psychology, The University of Sheffield, Sheffield, England
| | - Philip Hyland
- Department of Psychology, Maynooth University, Maynooth, Ireland
| | - Gerard Leavey
- School of Psychology, Ulster University, Coleraine, Northern Ireland
- Bamford Centre for Mental Health & Wellbeing, Ulster University, Coleraine, Northern Ireland
| | - Jamie Murphy
- School of Psychology, Ulster University, Coleraine, Northern Ireland
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24
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Howie C, Shevlin M, Shannon C, Davidson G, Bunting L, Grant A, McBride O, McCartan C, Murphy J, Nolan E, Schubotz D, Mulholland C. The structure of the Prodromal Questionnaire-16 (PQ-16) in a non-help-seeking youth population: Exploratory and confirmatory factor analyses study. Schizophr Res 2023; 261:281-286. [PMID: 37871410 DOI: 10.1016/j.schres.2023.10.013] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Revised: 07/25/2023] [Accepted: 10/18/2023] [Indexed: 10/25/2023]
Abstract
AIMS The present study aimed to examine the structure of the Prodromal Questionnaire-16 (PQ-16) in a non-help-seeking youth population through exploratory and confirmatory factor analysis. Previous studies have not examined the structure of this self-report measure in this age group outside a clinical setting. METHODS Participants (n = 1165) aged 11-19 years were recruited to an epidemiological study of young people in Northern Ireland, and completed the PQ-16 alongside other measures. The dataset was split randomly in two for separate factor analyses. A polychoric correlation matrix was created and exploratory factor analysis was used to identify the optimal number of factors. In addition, based on previous studies, six models were tested through confirmatory factor analysis to determine best fit. A one-factor, 3 two-factor, a three-factor and a four-factor model were all tested. RESULTS The exploratory factor analysis indicated a two-factor structure of the PQ-16 in this population, which we have labelled 'general unusual experiences' and 'hallucinations'. Confirmatory analysis indicated that the two-factor model identified through the exploratory analysis was the best fit for the data. DISCUSSION The present study suggests that the structure of the PQ-16 may vary across age groups in non-clinical settings, and adds further support to the validity of the PQ-16 is a cost-effective, easy to administer self-report measure that is suitable for use in non-help-seeking populations as a screening tool for prodromal symptoms.
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Affiliation(s)
- Clare Howie
- IMPACT Research Centre, Northern Health and Social Care Trust, Northern Ireland, United Kingdom of Great Britain and Northern Ireland.
| | - Mark Shevlin
- Ulster University, Northern Ireland, United Kingdom of Great Britain and Northern Ireland
| | - Ciarán Shannon
- IMPACT Research Centre, Northern Health and Social Care Trust, Northern Ireland, United Kingdom of Great Britain and Northern Ireland
| | - Gavin Davidson
- Queen's University Belfast, Northern Ireland, United Kingdom of Great Britain and Northern Ireland
| | - Lisa Bunting
- Queen's University Belfast, Northern Ireland, United Kingdom of Great Britain and Northern Ireland
| | - Anne Grant
- Queen's University Belfast, Northern Ireland, United Kingdom of Great Britain and Northern Ireland
| | - Orla McBride
- Queen's University Belfast, Northern Ireland, United Kingdom of Great Britain and Northern Ireland
| | - Claire McCartan
- IMPACT Research Centre, Northern Health and Social Care Trust, Northern Ireland, United Kingdom of Great Britain and Northern Ireland; Queen's University Belfast, Northern Ireland, United Kingdom of Great Britain and Northern Ireland
| | - Jamie Murphy
- Ulster University, Northern Ireland, United Kingdom of Great Britain and Northern Ireland
| | - Emma Nolan
- Ulster University, Northern Ireland, United Kingdom of Great Britain and Northern Ireland
| | - Dirk Schubotz
- Queen's University Belfast, Northern Ireland, United Kingdom of Great Britain and Northern Ireland
| | - Ciaran Mulholland
- IMPACT Research Centre, Northern Health and Social Care Trust, Northern Ireland, United Kingdom of Great Britain and Northern Ireland; Queen's University Belfast, Northern Ireland, United Kingdom of Great Britain and Northern Ireland
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25
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Fresno A, Ramos Alvarado N, Núñez D, Ulloa JL, Arriagada J, Cloitre M, Bisson JI, Roberts NP, Shevlin M, Karatzias T. Initial validation of the International Trauma Questionnaire (ITQ) in a sample of Chilean adults. Eur J Psychotraumatol 2023; 14:2263313. [PMID: 37815059 PMCID: PMC10566396 DOI: 10.1080/20008066.2023.2263313] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Accepted: 08/10/2023] [Indexed: 10/11/2023] Open
Abstract
BACKGROUND ICD-11 Posttraumatic Stress Disorder (PTSD) and Complex PTSD (CPTSD) are stress-related disorders. The International Trauma Questionnaire (ITQ) is a widely used instrument to assess PTSD and CPTSD. To date, there is no evidence of the psychometric characteristics of the ITQ in Latin American countries. OBJECTIVE The aim of this study was to assess the construct and concurrent validity of the Latin American Spanish adaptation of the ITQ in a sample of Chilean adults. METHODS A sample of 275 Chilean young adults completed the ITQ, a traumatic life events checklist, the Adverse Childhood Experiences Questionnaire, the Depression Anxiety Stress Scales-21, and the Columbia-Suicide Severity Rating Scale short version. Four alternative confirmatory factor analysis models were tested. Correlation analyses were performed to determine concurrent validity with associated measures (number of reported traumatic events, number of adverse childhood experiences, anxiety, depression, and suicidal risk). RESULTS The second-order two-factor (PTSD and DSO) and the correlated first-order six-factor model provided acceptable fit; however, the first model showed a better fit based on the BIC difference. The PTSD and DSO dimensions, as well as the six ITQ clusters showed positive correlations with reported number of traumatic life-events, reported number of adverse childhood experiences, levels of anxiety, depression, and suicidal risk. CONCLUSIONS The ITQ Latin American Spanish adaptation provides acceptable psychometric evidence to assess PTSD and CPTSD in accordance with the ICD-11.
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Affiliation(s)
- Andrés Fresno
- Programa de Investigación Asociativa (PIA) en Ciencias Cognitivas, Centro de Investigación en Ciencias Cognitivas (CICC), Facultad de Psicología, Universidad de Talca, Talca, Chile
- Centro de Derecho de las Minorías y Gestión de la Diversidad, Universidad de Talca, Talca, Chile
| | - Nadia Ramos Alvarado
- Programa de Investigación Asociativa (PIA) en Ciencias Cognitivas, Centro de Investigación en Ciencias Cognitivas (CICC), Facultad de Psicología, Universidad de Talca, Talca, Chile
- Centro de Derecho de las Minorías y Gestión de la Diversidad, Universidad de Talca, Talca, Chile
| | - Daniel Núñez
- Programa de Investigación Asociativa (PIA) en Ciencias Cognitivas, Centro de Investigación en Ciencias Cognitivas (CICC), Facultad de Psicología, Universidad de Talca, Talca, Chile
- Núcleo Milenio para Mejorar la Salud Mental de Adolescentes y Jóvenes (IMHAY), Santiago, Chile
| | - José Luis Ulloa
- Programa de Investigación Asociativa (PIA) en Ciencias Cognitivas, Centro de Investigación en Ciencias Cognitivas (CICC), Facultad de Psicología, Universidad de Talca, Talca, Chile
- Núcleo Milenio para Mejorar la Salud Mental de Adolescentes y Jóvenes (IMHAY), Santiago, Chile
| | - Jessica Arriagada
- Programa de Investigación Asociativa (PIA) en Ciencias Cognitivas, Centro de Investigación en Ciencias Cognitivas (CICC), Facultad de Psicología, Universidad de Talca, Talca, Chile
| | - Marylene Cloitre
- National Center for PTSD, Veterans Affairs Palo Alto Health Care System, Palo Alto, CA, USA
| | - Jonathan I. Bisson
- Division of Psychological Medicine and Clinical Neurosciences, Cardiff University School of Medicine, Cardiff, UK
| | - Neil P. Roberts
- Division of Psychological Medicine and Clinical Neurosciences, Cardiff University School of Medicine, Cardiff, UK
- Psychology and Psychological Therapies Directorate, Cardiff & Vale University Health Board, Cardiff, UK
| | - Mark Shevlin
- School of Psychology, Ulster University, Coleraine, Northern Ireland
| | - Thanos Karatzias
- School of Health & Social Care, Edinburgh Napier University, Edinburgh, UK
- Rivers Centre for Traumatic Stress, NHS Lothian, Edinburgh, UK
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26
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Knefel M, Karatzias T, Spinazzola J, Shevlin M, Ford JD. The relationship of posttraumatic stress disorder and developmental trauma disorder with childhood psychopathology: A network analysis. J Anxiety Disord 2023; 99:102766. [PMID: 37690357 DOI: 10.1016/j.janxdis.2023.102766] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Revised: 07/25/2023] [Accepted: 09/03/2023] [Indexed: 09/12/2023]
Abstract
OBJECTIVE Potentially traumatic experiences are a major risk factor for mental disorders in children and adolescents. Posttraumatic psychopathology includes trauma-specific disorders such as posttraumatic stress disorder (PTSD) as well as other psychiatric disorders. Developmental Trauma Disorder (DTD) has been proposed as a developmentally sensitive diagnosis. We aimed to further illuminate the co-occurrence of psychiatric conditions with DTD and PTSD. METHOD In a convenience sample of families of 507 children and adolescents (mean age = 12.11 years old, SD = 2.92; 48.5% female), we assessed DTD, PTSD, and screened for psychiatric disorders. We estimated network models including DTD, PTSD and ten psychiatric conditions. RESULTS We found that DTD and PTSD share both common and differential comorbidity features on disorder-, domain-, and symptom-level. The differential comorbidity patterns of the DTD and PTSD domains placed DTD close to both externalizing and internalizing psychopathology while PTSD was primarily linked to internalizing conditions. CONCLUSIONS Our study provides evidence for the complex clinical presentation of posttraumatic psychopathology over and above PTSD in children. DTD and PTSD provide useful and distinct diagnostic categories for children who are also experiencing internalizing conditions, and DTD may be especially relevant for children who are experiencing externalizing psychopathology.
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Affiliation(s)
- Matthias Knefel
- Faculty of Psychology, University of Vienna, Vienna, Austria; Department of Internal Medicine, Landesklinikum Baden , Baden bei Wien, Austria.
| | - Thanos Karatzias
- School of Health & Social Care, Edinburgh Napier University, Edinburgh, UK; Rivers Centre for Traumatic Stress, NHS Lothian, Edinburgh, UK
| | | | - Mark Shevlin
- Ulster University, School of Psychology, Coleraine, UK
| | - Julian D Ford
- University of Connecticut School of Medicine, Farmington, CT, USA
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27
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Karatzias T, Bohus M, Shevlin M, Hyland P, Bisson JI, Roberts NP, Cloitre M. Is it possible to differentiate ICD-11 complex PTSD from symptoms of borderline personality disorder? World Psychiatry 2023; 22:484-486. [PMID: 37713570 PMCID: PMC10503893 DOI: 10.1002/wps.21098] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/09/2023] [Indexed: 09/17/2023] Open
Affiliation(s)
- Thanos Karatzias
- Edinburgh Napier University, School of Health & Social Care, Edinburgh, UK
- NHS Lothian, Rivers Centre for Traumatic Stress, Edinburgh, UK
| | - Martin Bohus
- Institute of Psychiatric and Psychosomatic Psychotherapy, Central Institute of Mental Health Mannheim, Heidelberg University, Heidelberg, Germany
- McLean Hospital, Harvard Medical School, Boston, MA, USA
| | - Mark Shevlin
- School of Psychology, Ulster University, Coleraine, UK
| | - Philip Hyland
- Department of Psychology, Maynooth University, Kildare, Ireland
| | | | - Neil P Roberts
- School of Medicine, Cardiff University, Cardiff, UK
- Psychology and Psychological Therapies Directorate, Cardiff and Vale University Health Board, Cardiff, UK
| | - Marylène Cloitre
- National Center for PTSD Dissemination and Training Division, VA Palo Alto Health Care System, Palo Alto, CA, USA
- Department of Psychiatry and Behavioural Sciences, Stanford University, Stanford, CA, USA
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28
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Shevlin M, Redican E, Hyland P, Murphy J, Karatzias T, McBride O, Bennett K, Butter S, Hartman TK, Vallières F, Bentall RP. Symptoms and levels of ICD-11 Prolonged Grief Disorder in a representative community sample of UK adults. Soc Psychiatry Psychiatr Epidemiol 2023; 58:1535-1547. [PMID: 37039844 PMCID: PMC10098228 DOI: 10.1007/s00127-023-02469-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Accepted: 03/30/2023] [Indexed: 04/12/2023]
Abstract
BACKGROUND Prolonged Grief Disorder (PGD) is a new disorder included in ICD-11 (WHO, 2018). There is a growing body of literature surrounding the prevalence and correlates of ICD-11 PGD symptoms as assessed using various measures. This study was the first to assess levels of ICD-11 PGD symptoms as measured by the International Prolonged Grief Disorder Scale (IPGDS), a self-report scale directly aligned with the ICD-11 definition of PGD, among the United Kingdom adult general population, and identify correlates. METHOD Participants included 2025 adults who participated in Wave 5 of the COVID-19 Psychological Research Consortium Study (C19PRC-UK). Prevalence rates of PGD were estimated based on two commonly used algorithms defined as 'strict' and 'moderate'. Sociodemographic, loss-related, and mental health correlates (i.e., anxiety, depression, mental health treatment seeking, loneliness) of strict and moderate PGD were then examined using multinomial logistic regressions. RESULTS It was found that 2.4% (n = 43) of participants met probable caseness for PGD using the strict criteria while 7.9% (n = 140) met probable caseness for PGD using the moderate criteria. Multinomial logistic regression analysis results showed, as predicted, that income, time since bereavement, death of a child, religiosity, and depression were associated with both moderate and strict PGD. Correlates of moderate PGD included country of residence, urbanicity, younger age of bereaved, and loneliness. CONCLUSIONS This study highlights that some symptoms of PGD are commonly reported in the general population, although relatively few meet the criteria for clinical significance. The routine assessment for PGD following a bereavement is discussed and the development of appropriate interventions are recommended.
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Affiliation(s)
- Mark Shevlin
- School of Psychology, Ulster University, Cromore Road, Coleraine, BT52 1SA Northern Ireland
| | - Enya Redican
- School of Psychology, Ulster University, Cromore Road, Coleraine, BT52 1SA Northern Ireland
| | | | - Jamie Murphy
- School of Psychology, Ulster University, Cromore Road, Coleraine, BT52 1SA Northern Ireland
| | | | - Orla McBride
- School of Psychology, Ulster University, Cromore Road, Coleraine, BT52 1SA Northern Ireland
| | | | - Sarah Butter
- School of Psychology, Ulster University, Cromore Road, Coleraine, BT52 1SA Northern Ireland
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29
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Hyland P, Redican E, Karatzias T, Shevlin M. Assessing the validity and reliability of the International Anxiety Questionnaire and the International Depression Questionnaire in two bereaved national samples. Clin Psychol Psychother 2023. [PMID: 37776046 DOI: 10.1002/cpp.2917] [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: 06/29/2023] [Revised: 09/17/2023] [Accepted: 09/18/2023] [Indexed: 10/01/2023]
Abstract
The International Anxiety Questionnaire (IAQ) and International Depression Questionnaire (IDQ) are self-report measures of ICD-11 Generalized Anxiety Disorder (ICD-11 GAD) and ICD-11 Single Episode Depressive Disorder (ICD-11 DD). This study tested the psychometric properties of these scales in two samples of bereaved adults from the United Kingdom and the Republic of Ireland. Confirmatory factor analysis (CFA) was used to test the combined dimensionality and measurement invariance of the IAQ and IDQ across the United Kingdom (n = 1012) and Irish (n = 1011) samples. Differential item functioning (DIF) was tested using multiple indicator multiple cause (MIMIC) modelling while convergent validity was also assessed. CFA results supported a correlated two-factor model in both samples. The MIMIC model showed that the IDQ item "Had recurrent thoughts of death or suicide" showed DIF and the effect was small. Internal reliability of the scales were high and convergent validity was supported. The prevalence of ICD-11 GAD was 18.6% and 16.1% and ICD-11 DD was 13.8% and 10.5% in the United Kingdom and Irish samples, respectively. Findings of the study provide support for the validity, measurement invariance, and reliability of the IAQ and IDQ among two bereaved national samples.
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Affiliation(s)
- Philip Hyland
- Department of Psychology, Maynooth University, Maynooth, Ireland
| | - Enya Redican
- School of Psychology, Ulster University, Ulster, UK
| | - Thanos Karatzias
- School of Health & Social Care, Napier University, Edinburgh, UK
| | - Mark Shevlin
- School of Psychology, Ulster University, Ulster, UK
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30
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Martsenkovskyi D, Karatzias T, Hyland P, Shevlin M, Ben-Ezra M, McElroy E, Redican E, Vang ML, Cloitre M, Ho GWK, Lorberg B, Martsenkovsky I. Parent-reported posttraumatic stress reactions in children and adolescents: Findings from the mental health of parents and children in Ukraine study. Psychol Trauma 2023:2024-11119-001. [PMID: 37747495 DOI: 10.1037/tra0001583] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/26/2023]
Abstract
BACKGROUND Despite the long-standing ongoing war in Ukraine, information regarding war-related negative mental health outcomes in children is limited. A nationwide sample of parents in Ukraine was surveyed to assess posttraumatic stress disorder (PTSD) symptoms in their children and to identify risk factors associated with child PTSD status. METHOD A nationwide opportunistic sample of 1,238 parents reported on a single randomly chosen child within their household as part of The Mental Health of Parents and Children in Ukraine Study. Data were collected approximately 6 months after the war escalation in February 2022. The prevalence of PTSD was estimated using the parent-reported Child and Adolescent Trauma Screen (CATS). RESULTS Based on parental reports, 17.5% of preschoolers and 12.6% of school-age children met Diagnostic and Statistical Manual of Mental Disorders (5th ed.) criteria for PTSD. Delay in milestone development (AOR = 2.38, 95% confidence interval [CI] [1.38-4.08]), having a parent affiliated with the emergency services or army (AOR = 2.13, [1.28-3.53]), parental PTSD/complex PTSD status (AOR = 1.88, [1.22-2.89]), and mean changes in parental anxiety (AOR = 1.98, [1.44-2.72]) were among the strongest predictors of increased risk of pediatric PTSD. CONCLUSION Russia's war escalation in Ukraine resulted in an increased estimated prevalence of war-related PTSD in children of various ages. Urgent efforts to increase the capacity of national pediatric mental health services are critically needed to mitigate these challenges in an environment of limited financial and human resources. (PsycInfo Database Record (c) 2024 APA, all rights reserved).
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Affiliation(s)
| | | | | | | | | | | | | | | | - Marylene Cloitre
- National Center for PTSD, Dissemination and Training Division, VA Palo Alto Health Care System
| | - Grace W K Ho
- School of Nursing, Hong Kong Polytechnic University
| | | | - Igor Martsenkovsky
- Department of Child Psychiatry, Institute of Psychiatry, Forensic Psychiatric Examination and Drug Monitoring, Ministry of Health of Ukraine
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Karatzias T, Bohus M, Shevlin M, Hyland P, Bisson JI, Roberts N, Cloitre M. Distinguishing between ICD-11 complex post-traumatic stress disorder and borderline personality disorder: clinical guide and recommendations for future research. Br J Psychiatry 2023; 223:403-406. [PMID: 37381070 DOI: 10.1192/bjp.2023.80] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/30/2023]
Abstract
Although complex post-traumatic stress disorder and borderline personality disorder are distinct disorders, there is confusion in clinical practice regarding the similarities between the diagnostic profiles of these conditions. We summarise the differences in the diagnostic criteria that are clinically informative and we illustrate these with case studies to enable diagnostic accuracy in clinical practice.
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Affiliation(s)
- Thanos Karatzias
- School of Health & Social Care, Edinburgh Napier University, Edinburgh, UK; and NHS Lothian, Rivers Centre for Traumatic Stress, Edinburgh, UK
| | - Martin Bohus
- Institute of Psychiatric and Psychosomatic Psychotherapy, Central Institute of Mental Health, Mannheim, Germany; Medical Faculty Mannheim, Heidelberg University, Heidelberg, Germany; and McLean Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Mark Shevlin
- School of Psychology, Ulster University, Londonderry, Northern Ireland
| | - Philip Hyland
- Department of Psychology, Maynooth University, Kildare, Ireland
| | | | - Neil Roberts
- School of Medicine, Cardiff University, Cardiff, UK; and Psychology and Psychological Therapies Directorate, Cardiff and Vale University Health Board, Cardiff, UK
| | - Marylène Cloitre
- National Center for PTSD Dissemination and Training Division, VA Palo Alto Health Care System, Palo Alto, California, USA; and Department of Psychiatry and Behavioural Sciences, Stanford University, Stanford, California, USA
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32
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Redican E, Sachser C, Pfeiffer E, Martsenkovskyi D, Hyland P, Karatzias T, Shevlin M. Validation of the Ukrainian caregiver-report version of the Child and Adolescent Trauma Screen (CATS) in children and adolescents in Ukraine. Psychol Trauma 2023:2024-01638-001. [PMID: 37616083 DOI: 10.1037/tra0001570] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 08/25/2023]
Abstract
OBJECTIVE Emerging research indicates that the ongoing conflict in Ukraine has led to an increased prevalence of war-related posttraumatic stress disorder (PTSD) in children and adolescents. The current study sought to test the psychometric properties of a Ukrainian-translated measure of PTSD for children and adolescents; the Child and Adolescent Trauma Screen (CATS; Sachser et al., 2017). METHOD Participants were an opportunistic sample of N = 2,004 parents living in Ukraine who provided data on themselves and one target child in their household as part of The Mental Health of Parents and Children in Ukraine Study. The latent structure of the parent-reported CATS was tested using confirmatory factor analysis, composite reliability estimates were estimated, and criterion validity was assessed. RESULTS The latent structure of the parent-reported CATS was best reflected by a three-factor model and a four-factor model in the preschool and child and adolescent samples, respectively. Estimates of internal reliability were high for both samples. Criterion validity was supported through associations with external measures of internalizing, externalizing, and attention problems. Parent-report child milestone development delays and prior psychological or pharmacological support were associated with higher average scores on the CATS symptom scales. The prevalence of probable PTSD for the preschool sample was 15.4% (n = 77) and the prevalence of probable PTSD for the child and adolescent sample was 14.4% (n = 217). DISCUSSION This study supports the psychometric properties of the Ukrainian parent-reported CATS which can be used routinely in clinical practice for the caregiver-rated assessment of PTSD. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
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Affiliation(s)
| | - Cedric Sachser
- Clinic for Child and Adolescent Psychiatry/Psychotherapy, University of Ulm
| | - Elisa Pfeiffer
- Clinic for Child and Adolescent Psychiatry/Psychotherapy, University of Ulm
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Ho GWK, Vang ML, Martsenkovskyi D, Karatzias T, Ben-Ezra M, McElroy E, Redican E, Cloitre M, Lorberg B, Hyland P, Shevlin M. Investigating the latent structure of the International Trauma Questionnaire to assess ICD-11 posttraumatic stress disorder (PTSD) and complex PTSD in an adult civilian sample during the Ukraine war. J Trauma Stress 2023; 36:820-829. [PMID: 37339126 DOI: 10.1002/jts.22943] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Revised: 04/26/2023] [Accepted: 04/26/2023] [Indexed: 06/22/2023]
Abstract
The symptom structure of ICD-11 posttraumatic stress disorder (PTSD) and complex PTSD (CPTSD) and the validity of the International Trauma Questionnaire (ITQ) are yet to be tested among civilians in an active war zone. The present investigation examined the factor structure of the ITQ, the internal consistency of observed scores, and their associations with demographic characteristics and war-related experiences using a nationwide sample of 2,004 adults from the general population of Ukraine approximately 6 months after the full-scale Russian invasion in 2022. Overall, rates of endorsement across all symptom clusters were high. The mean total number of war-related stressors reported was 9.07 (SD = 4.35, range: 1-26). Internal reliability was good for all six ITQ subscales, Cronbach's αs = .73-.88, and the correlated six-factor model was found to provide the best representation of the latent structure of the ITQ in the present sample based on fit indices. There was evidence of a dose-response relationship, with increasing scores on all symptom clusters associated with higher total reported war-related stressors.
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Affiliation(s)
- Grace W K Ho
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong
| | - Maria Louison Vang
- Centre for Psychotraumatology, University of Southern Denmark, Odense, Denmark
| | - Dmytro Martsenkovskyi
- Department of Psychiatry and Narcology, Bogomolets National Medical University, Kyiv, Ukraine
- SI Institute of Psychiatry, Forensic Psychiatric Examination and Drug Monitoring of Ministry of Health of Ukraine, Kyiv, Ukraine
| | - Thanos Karatzias
- School of Health & Social Care, Edinburgh Napier University, Edinburgh, United Kingdom
| | | | - Eoin McElroy
- School of Psychology, Ulster University, Derry, Northern Ireland, United Kingdom
| | - Enya Redican
- School of Psychology, Ulster University, Derry, Northern Ireland, United Kingdom
| | - Marylene Cloitre
- National Center for PTSD, Dissemination and Training Division, VA Palo Alto Health Care System, Palo Alto, California, USA
- Department of Psychiatry and Behavioural Sciences, Stanford University, Stanford, California, USA
| | - Boris Lorberg
- Department of Psychiatry, UMass Chan Medical School, Massachusetts, USA
| | - Philip Hyland
- Department of Psychology, Maynooth University, Kildare, Ireland
| | - Mark Shevlin
- School of Psychology, Ulster University, Derry, Northern Ireland, United Kingdom
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Alpay EH, Redican E, Hyland P, Shevlin M. Translation and validation of the Turkish forms of the International Depression Questionnaire (IDQ) and the International Anxiety Questionnaire (IAQ). Acta Psychol (Amst) 2023; 238:103988. [PMID: 37454587 DOI: 10.1016/j.actpsy.2023.103988] [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] [Received: 03/28/2023] [Revised: 07/11/2023] [Accepted: 07/11/2023] [Indexed: 07/18/2023] Open
Abstract
BACKGROUND The 11th version of the International Classification of Diseases (ICD-11) included revised formulations of single episode depressive disorder (DD) and generalized anxiety disorder (GAD). Consequently, the International Depression Questionnaire (IDQ) and International Anxiety Questionnaire (IAQ) have been developed as self-report measures which directly align with the ICD-11 description of DD and GAD, respectively. OBJECTIVE The current study sought to (1) test the factorial validity of the Turkish translations of the IDQ and IAQ, (2) evaluate their internal reliability, (3) determine how meeting diagnostic requirements for ICD-11 DD and ICD-11 GAD vary across different demographic variables, and (4) determine the convergent validity of the Turkish translations of the IDQ and IAQ. METHODS Participants were a community sample of 1455 Turkish adults and largely comprised of university students. This study used confirmatory factor analysis (CFA) to test the latent structure of both scales. Prevalence rates of ICD-11 GAD and DD were also estimated, and differences in prevalence rates according to gender and relationship status were examined. RESULTS The CFA results indicated that both scales were unidimensional. Both scales demonstrated high levels of internal consistency. The prevalence of ICD-11 DD and GAD was 26.6 % and 28.5 %, respectively. Rates of probable ICD-11 DD and GAD were highest for females and single participants. Convergent validity was indicated by strong associations with external measures of depression and anxiety. CONCLUSION Findings from this study provide support for the validity and reliability of the Turkish versions of the IDQ and IAQ in a large community sample.
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Affiliation(s)
- Emre Han Alpay
- Department of Psychology, Mersin University, Mersin, Türkiye
| | - Enya Redican
- Ulster University, School of Psychology, Coleraine, UK
| | - Philip Hyland
- Department of Psychology, Maynooth University, Ireland
| | - Mark Shevlin
- Ulster University, School of Psychology, Coleraine, UK.
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Abstract
The 11th version of the International Classification of Diseases (ICD-11) includes complex posttraumatic stress disorder (CPTSD) as a separate diagnostic entity alongside posttraumatic stress disorder (PTSD). ICD-11 CPTSD is defined by six sets of symptoms, three that are shared with PTSD (reexperiencing in the here and now, avoidance, and sense of current threat) and three (affective dysregulation, negative self-concept, and disturbances in relationships) representing pervasive "disturbances in self-organization" (DSO). There is considerable evidence supporting the construct validity of ICD-11 CPTSD, but no theoretical account of its development has thus far been presented. A theory is needed to explain several phenomena that are especially relevant to ICD-11 CPTSD such as the role played by prolonged and repeated trauma exposure, the functional independence between PTSD and DSO symptoms, and diagnostic heterogeneity following trauma exposure. The memory and identity theory of ICD-11 CPTSD states that single and multiple trauma exposure occur in a context of individual vulnerability which interact to give rise to intrusive, sensation-based traumatic memories and negative identities which, together, produce the PTSD and DSO symptoms that define ICD-11 CPTSD. The model emphasizes that the two major and related causal processes of intrusive memories and negative identities exist on a continuum from prereflective experience to full self-awareness. Theoretically derived implications for the assessment and treatment of ICD-11 CPTSD are discussed, as well as areas for future research and model testing. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
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Affiliation(s)
| | | | - Chris R Brewin
- University College London, Division of Psychology and Language Sciences
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Hyland P, Vallières F, McBride O, Murphy J, Shevlin M, Bentall RP, Butter S, Hartman TK, Karatzias T, MacLachlan M, Maguire R, Power JM, Spikol E, Daly M. Mental health of adults in Ireland during the first year of the COVID-19 pandemic: results from a nationally representative, longitudinal study. Psychol Med 2023; 53:3766-3768. [PMID: 34629129 PMCID: PMC8564049 DOI: 10.1017/s0033291721004360] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Revised: 09/30/2021] [Accepted: 10/06/2021] [Indexed: 12/26/2022]
Affiliation(s)
- Philip Hyland
- Department of Psychology, Maynooth University, Kildare, Ireland
| | | | - Orla McBride
- School of Psychology, Ulster University, Coleraine, Northern Ireland
| | - Jamie Murphy
- School of Psychology, Ulster University, Coleraine, Northern Ireland
| | - Mark Shevlin
- School of Psychology, Ulster University, Coleraine, Northern Ireland
| | - Richard P. Bentall
- Department of Psychology, The University of Sheffield, Sheffield, England
| | - Sarah Butter
- Department of Psychology, The University of Sheffield, Sheffield, England
| | - Todd K. Hartman
- Department of Social Statistics, The University of Manchester, Manchester, England
| | - Thanos Karatzias
- School of Health & Social Care, Edinburgh Napier University, Edinburgh, Scotland
| | - Malcolm MacLachlan
- Department of Psychology, Maynooth University, Kildare, Ireland
- HSE National Clinical Programme for People with Disability, Dublin, Ireland
| | - Rebecca Maguire
- Department of Psychology, Maynooth University, Kildare, Ireland
| | | | - Eric Spikol
- Department of Psychology, Maynooth University, Kildare, Ireland
| | - Michael Daly
- Department of Psychology, Maynooth University, Kildare, Ireland
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Bunting L, McCartan C, Davidson G, Grant A, Mulholland C, Schubotz D, Hamill R, McBride O, Murphy J, Nolan E, Shevlin M. The influence of adverse and positive childhood experiences on young people's mental health and experiences of self-harm and suicidal ideation. Child Abuse Negl 2023; 140:106159. [PMID: 37028255 DOI: 10.1016/j.chiabu.2023.106159] [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] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Revised: 02/27/2023] [Accepted: 03/23/2023] [Indexed: 05/06/2023]
Abstract
BACKGROUND Few studies have examined the interaction of adverse childhood experiences (ACEs) and positive childhood experiences (PCEs) with mental health outcomes in nationally representative European populations. OBJECTIVE The primary objective was to test models of resilience through investigating associations between ACEs and PCEs and young people's risk of common mood and anxiety disorders, self-harm and suicidal ideation. PARTICIPANTS AND SETTING Data were from the Northern Ireland Youth Wellbeing Survey (NIYWS), a stratified random probability household survey conducted between June 2019 and March 2020. Analysis is based on data from adolescents aged 11-19 years (n = 1299). METHOD Logistic regression was used to test the direct effects of ACEs and PCEs on mental health outcomes and the moderating effect of PCEs at different levels of ACE exposure. RESULTS Prevalence rates of mental health outcomes were: common mood and anxiety disorders (16 %); self-harm (10 %); suicidal ideation (12 %). ACEs and PCEs both independently predicted common mood and anxiety disorders, self-harm and suicidal ideation. Every additional ACE increased the likelihood of a common mood and anxiety disorder (81 %), self-harm (88 %) and suicidal ideation (88 %). Every additional PCE reduced common mood and anxiety disorders (14 %), self-harm (13 %) and suicidal ideation (7 %). There was no moderating effect of PCEs on ACEs and mental health outcomes. CONCLUSION The findings suggest that PCEs act largely independently of ACEs and that initiatives to increase PCEs can assist in the prevention of mental health problems.
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Affiliation(s)
- Lisa Bunting
- Queen's University Belfast, United Kingdom of Great Britain and Northern Ireland.
| | - Claire McCartan
- Queen's University Belfast, United Kingdom of Great Britain and Northern Ireland
| | - Gavin Davidson
- Queen's University Belfast, United Kingdom of Great Britain and Northern Ireland
| | - Anne Grant
- Queen's University Belfast, United Kingdom of Great Britain and Northern Ireland
| | - Ciaran Mulholland
- Queen's University Belfast, United Kingdom of Great Britain and Northern Ireland
| | - Dirk Schubotz
- Queen's University Belfast, United Kingdom of Great Britain and Northern Ireland
| | - Ryan Hamill
- Queen's University Belfast, United Kingdom of Great Britain and Northern Ireland
| | - Orla McBride
- Ulster University, United Kingdom of Great Britain and Northern Ireland
| | - Jamie Murphy
- Ulster University, United Kingdom of Great Britain and Northern Ireland
| | - Emma Nolan
- Ulster University, United Kingdom of Great Britain and Northern Ireland
| | - Mark Shevlin
- Ulster University, United Kingdom of Great Britain and Northern Ireland
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Redican E, Vang ML, Shevlin M, Ghazali S, Elklit A. The co-occurrence of potentially traumatic events (PTEs) and their associations with posttraumatic stress disorder (PTSD) in Indian and Malaysian adolescents. Acta Psychol (Amst) 2023; 235:103896. [PMID: 36990035 DOI: 10.1016/j.actpsy.2023.103896] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Revised: 03/06/2023] [Accepted: 03/20/2023] [Indexed: 03/30/2023] Open
Abstract
BACKGROUND Although it is well-established that people can experience multiple traumatic events, there are few studies examining the co-occurrence of such experiences in non-Western nations. The current study sought to examine the occurrence of multiple potentially traumatic experiences (PTEs) and their associations with posttraumatic stress disorder (PTSD) among adolescents from two Asian nations. METHODS Latent class analysis (LCA) was employed to model the co-occurrence of PTEs in two school samples of adolescents from India (n = 411) and Malaysia (n = 469). Demographic correlates (i.e., sex, age, household composition, parent education) of the latent classes and the association between latent class membership and probable diagnosis of posttraumatic stress disorder (PTSD) were examined. RESULTS The LCA identified three latent classes for the Indian sample: 'Low Risk - moderate sexual trauma', 'Moderate Risk', and 'High Risk'. Similarly, three classes were also identified for the Malaysian sample: 'Low Risk', 'Moderate Risk', and 'High Risk'. Membership of 'Moderate Risk' was associated with male sex in both samples, and with older age and lower levels of parental education attainment in the Malaysian sample. No correlates of 'High Risk' class were identified in either sample. Membership of the 'High Risk' class was significantly associated with probable PTSD diagnosis in both samples, while membership of the 'Moderate Risk' class was associated with probable PTSD diagnosis in the Malaysian sample. CONCLUSION Findings from this study correspond with Western studies indicating co-occurrence of PTEs to be common and to represent a salient risk factor for the development of PTSD.
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Affiliation(s)
- Enya Redican
- Department of Psychology, Ulster University, United Kingdom.
| | - Maria Louison Vang
- Department of Psychology, The National Center of Psychotraumatology, Denmark.
| | - Mark Shevlin
- Department of Psychology, Ulster University, United Kingdom.
| | - Siti Ghazali
- Department of Psychological Medicine, Faculty of Medicine and Health Sciences, Universiti Malaysia Sarawak, Malaysia.
| | - Ask Elklit
- Department of Psychology, The National Center of Psychotraumatology, Denmark.
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Charak R, Cano-Gonzalez I, Ronzón-Tirado R, Ford JD, Byllesby BM, Shevlin M, Karatzias T, Hyland P, Cloitre M. Factor structure of the international trauma questionnaire in trauma exposed LGBTQ+ adults: Role of cumulative traumatic events and minority stress heterosexist experiences. Psychol Trauma 2023; 15:628-636. [PMID: 36689378 DOI: 10.1037/tra0001440] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
UNLABELLED Exposure to prolonged and/or multiple types of psychological trauma and stressors has been shown to be more strongly associated with ICD-11 complex posttraumatic stress disorder (CPTSD) than posttraumatic stress disorder (PTSD). Lesbian, gay, bisexual, trans- and queer adults (LGBTQ+) are at a heightened risk of exposure to traumatic events, and minority stressors including harassment, discrimination, rejection by family, and isolation. OBJECTIVE To examine the factor structure of the international trauma questionnaire (ITQ), a self-report measure of PTSD and CPTSD, and the associations of cumulative lifetime trauma exposure assessed via the life events checklist and minority stress assessed via the daily heterosexist experiences scale, with CPTSD (three PTSD symptom clusters, three clusters reflecting disturbances in self-organization [DSO]) among LGBTQ + adults. METHOD Participants comprised 225 LGBTQ + adults (including 74 transgender and gender diverse individuals; age range: 18-60 years; M/SD = 31.35/9.48) residing in Spain. RESULTS Confirmatory factor analyses indicated that both a first-order six-factor model and a hierarchical two-factor model, comprising PTSD and DSO as second-order factors, fit the data best. Cumulative traumatic events score was associated with PTSD, and cumulative minority stress was associated with PTSD and DSO. Among the minority stress subscales, harassment based on gender expression was positively associated with all symptom clusters of PTSD and DSO. CONCLUSION This is the first study to examine the role of minority stressors alongside exposure to psychological traumas in ICD-11 PTSD and CPTSD and emphasizes the inclusion of minority stressors in trauma-related assessments. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
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Affiliation(s)
- Ruby Charak
- Department of Psychological Science, University of Texas Rio Grande Valley
| | - Ines Cano-Gonzalez
- Department of Psychological Science, University of Texas Rio Grande Valley
| | | | - Julian D Ford
- Department of Psychiatry, University of Connecticut School of Medicine
| | | | | | | | | | - Marylene Cloitre
- National Center for PTSD, Dissemination and Training Division, VA Palo Alto Health Care System
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Shevlin M, Butter S, McBride O, Murphy J, Gibson-Miller J, Hartman TK, Levita L, Mason L, Martinez AP, McKay R, Stocks TVA, Bennett KM, Hyland P, Vallieres F, Bentall RP. Psychological responses to the COVID-19 pandemic are heterogeneous but have stabilised over time: 1 year longitudinal follow-up of the COVID-19 Psychological Research Consortium (C19PRC) study. Psychol Med 2023; 53:3245-3247. [PMID: 34538283 PMCID: PMC8485012 DOI: 10.1017/s0033291721004025] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2021] [Revised: 09/10/2021] [Accepted: 09/14/2021] [Indexed: 11/19/2022]
Affiliation(s)
- Mark Shevlin
- Department of Psychology, Ulster University, Coleraine, UK
| | | | - Orla McBride
- Department of Psychology, Ulster University, Coleraine, UK
| | - Jamie Murphy
- Department of Psychology, Ulster University, Coleraine, UK
| | | | | | | | | | | | - Ryan McKay
- Royal Holloway, University of London, London, UK
| | | | | | | | | | - Richard P. Bentall
- University of Sheffield, Sheffield, UK
- Liverpool University, Liverpool, UK
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Redican E, Rawers C, McElroy E, Hyland P, Karatzias T, Ben-Ezra M, Shevlin M. Development and initial validation of a short form of the Memories of Home and Family Scale. Advers Resil Sci 2023; 4:1-10. [PMID: 37361561 PMCID: PMC10148702 DOI: 10.1007/s42844-023-00097-x] [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] [Subscribe] [Scholar Register] [Accepted: 04/18/2023] [Indexed: 06/28/2023]
Abstract
The Memories of Home and Family Scale (MHFS; Shevlin et al., 2022) was developed as a multidimensional measure of subjective memories of experiences at home and with family during childhood. Due to the length of the scale, a short version of the MHFS (MHFS-SF) has been developed. Data were from Wave 7 of the COVID-19 Psychological Research Consortium Study (C19PRC-UK), a population based UK survey (N = 1405). Two items with the highest factor loadings from each of the six dimensions of the original MHFS were selected for inclusion. Confirmatory factor analytic (CFA) models were estimated to test the dimensionality of the scale. Convergent and discriminant validity were tested by examining associations with criterion variables. CFA results supported the multidimensionality of the scale. MHFS-SF total and sub-scale scores were negatively correlated with measures of depression, anxiety, loneliness, and paranoia, and were positively correlated with wellbeing. Regression analyses revealed that MHFS-SF total and sub-scale scores significantly predicted loneliness, paranoia, and wellbeing, even after accounting for age, gender, and current internalising symptoms. Results from this study suggest that the MHFS-SF scores retain the excellent psychometric properties of the original scale while improving efficiency. The MHFS-SF demonstrated high levels of convergent and discriminant validity with mental health and wellbeing measures. Future research should seek to validate the MHFS-SF in different populations and assess its usefulness in clinical settings. Supplementary Information The online version contains supplementary material available at 10.1007/s42844-023-00097-x.
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Affiliation(s)
- Enya Redican
- Ulster University, School of Psychology, Cromore Road, Coleraine, Co, Londonderry, BT52 1SA UK
| | - Caitlyn Rawers
- Ulster University, School of Psychology, Cromore Road, Coleraine, Co, Londonderry, BT52 1SA UK
| | - Eoin McElroy
- Ulster University, School of Psychology, Cromore Road, Coleraine, Co, Londonderry, BT52 1SA UK
| | - Philip Hyland
- Department of Psychology, Maynooth University, Kildare, Ireland
| | - Thanos Karatzias
- Edinburgh Napier University, School of Health and Social Care, Edinburgh, UK
| | | | - Mark Shevlin
- Ulster University, School of Psychology, Cromore Road, Coleraine, Co, Londonderry, BT52 1SA UK
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Shannon S, Shevlin M, Brick N, Breslin G. Frequency, intensity and duration of muscle strengthening activity and associations with mental health. J Affect Disord 2023; 325:41-47. [PMID: 36587908 DOI: 10.1016/j.jad.2022.12.063] [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] [Received: 01/28/2022] [Revised: 12/05/2022] [Accepted: 12/17/2022] [Indexed: 12/31/2022]
Abstract
OBJECTIVES Despite growing emphasis on the benefits of physical activity for promoting mental health, inclusion of muscle-strengthening (MS) (e.g., body-weight exercises, resistance machines) activities is limited. Notably, few studies collectively assess MS behavioural frequency, duration, and intensity. To address the gap, the current study examined associations between frequency (days), intensity (rating of perceived exertion in relation to repetitions in reserve [RPE/RIR]), and duration (minutes per typical session) of MS activities on anxiety, depression, and mental well-being. METHOD A cross-sectional study of 601 participants (Mean age = 30.92 years [SD = 12.70]; 57.7 % female) across Ireland was conducted. Participants completed a self-report questionnaire containing MS instruments previously used, or adapted from valid and reliable measures (i.e., International Physical Activity Questionnaire IPAQ, RPE/RIR), alongside, the Generalized Anxiety Disorder-7 (GAD-7), Patient Health Questionnaire-8 (PHQ-8) and the Mental Health Continuum- Short Form (MHC-SF). A multivariate regression model was tested in MPLUS, using dummy coding for MS frequency in relation to no activity (i.e., 0-days) non-adherence (i.e., 1-day), adherence (i.e., 2-days) and enhanced adherence (i.e., ≥3 days) to the MS public health guidelines, with the mental health variables representing the dependent variables. Intensity and duration were specified in the model as continuous variables; gender and age were included as statistical controls. RESULTS Three or more days engaged in MS activities was associated with fewer anxiety (β = -0.12, p < .05) and depression (β = -0.14, p < .01) symptoms. Increased intensity had a negative association with anxiety (β = -0.10, p < .05) and depression (β = -0.15, p < .001). Unexpectedly, adherence to the MS guidelines (2-days) did not predict any of the mental health outcomes, whereas 1-day of MS activity was associated with fewer depression symptoms (β = -0.11). No effects were observed for mental well-being, and MS duration exerted a null effect across all mental health outcomes. CONCLUSION Higher frequency and intensity of MS activities may protect against anxiety and depression symptoms. Doing some MS activities (at least 1-day) is likely more beneficial than none for depression. Evidence-based, MS interventions may help curb mental illness rates, and future longitudinal, intervention-based research could consider inclusion of MS frequency, intensity and duration variables to enhance efforts to identify at-risk groups and trends within physical activity and mental illness surveillance.
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Affiliation(s)
- Stephen Shannon
- Sport and Exercise Sciences Research Institute, Ulster University Jordanstown Campus, Shore Road, Newtownabbey, Northern Ireland BT370QB, UK; Bamford Centre for Mental Health and Wellbeing, Ulster University Jordanstown Campus, Shore Road, Newtownabbey, Northern Ireland BT370QB, UK.
| | - Mark Shevlin
- School of Psychology, Ulster University Coleraine Campus, Cromore Road, Coleraine, Northern Ireland BT521SA, UK
| | - Noel Brick
- School of Psychology, Ulster University Coleraine Campus, Cromore Road, Coleraine, Northern Ireland BT521SA, UK
| | - Gavin Breslin
- Bamford Centre for Mental Health and Wellbeing, Ulster University Jordanstown Campus, Shore Road, Newtownabbey, Northern Ireland BT370QB, UK; School of Psychology, Ulster University Coleraine Campus, Cromore Road, Coleraine, Northern Ireland BT521SA, UK
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Karatzias T, Shevlin M, Ben-Ezra M, McElroy E, Redican E, Vang ML, Cloitre M, Ho GWK, Lorberg B, Martsenkovskyi D, Hyland P. War exposure, posttraumatic stress disorder, and complex posttraumatic stress disorder among parents living in Ukraine during the Russian war. Acta Psychiatr Scand 2023; 147:276-285. [PMID: 36625445 DOI: 10.1111/acps.13529] [Citation(s) in RCA: 17] [Impact Index Per Article: 17.0] [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] [Received: 10/01/2022] [Revised: 12/19/2022] [Accepted: 12/21/2022] [Indexed: 01/11/2023]
Abstract
BACKGROUND High rates of posttraumatic stress disorder (PTSD) have been documented in war-affected populations. The prevalence of Complex PTSD (CPTSD) has never been assessed in an active war zone. Here, we provide initial data on war-related experiences, and prevalence rates of ICD-11 PTSD and CPTSD in a large sample of adults in Ukraine during the Russian war. We also examined how war-related stressors, PTSD, and CPTSD were associated with age, sex, and living location in Ukraine. METHOD Self-report data were gathered from a nationwide sample of 2004 adult parents of children under 18 from the general population of Ukraine approximately 6 months after Russia's invasion. RESULTS All participants were exposed to at least one war-related stressor, and the mean number of exposures was 9.07 (range = 1-26). Additionally, 25.9% (95% CI = 23.9%, 27.8%) met diagnostic requirements for PTSD and 14.6% (95% CI = 12.9%, 16.0%) met requirements for CPTSD. There was evidence of a strong dose-response relationship between war-related stressors and meeting criteria for PTSD and CPTSD. Participants who had the highest exposure to war-related stressors were significantly more likely to meet the requirements for PTSD (OR = 4.20; 95% CI = 2.96-5.95) and CPTSD (OR = 8.12; 95% CI = 5.11-12.91) compared to the least exposed. CONCLUSIONS Humanitarian responses to the mental health needs of the Ukrainian population will need to take account of posttraumatic stress reactions. Education in diagnosing and treating PTSD/CPTSD, especially in the situation of a significant lack of human resources and continuing displacement of the population, is necessary.
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Affiliation(s)
- Thanos Karatzias
- School of Health & Social Care, Edinburgh Napier University, Edinburgh, UK
| | - Mark Shevlin
- School of Psychology, Ulster University, Coleraine, Northern Ireland, UK
| | | | - Eoin McElroy
- School of Psychology, Ulster University, Derry, Northern Ireland, UK
| | - Enya Redican
- School of Psychology, Ulster University, Derry, Northern Ireland, UK
| | - Maria Louison Vang
- Centre for Psychotraumatology, University of Southern Denmark, Odense, Denmark
| | - Marylene Cloitre
- National Center for PTSD Dissemination and Training Division, VA Palo Alto Health Care System, California, USA.,Department of Psychiatry and Behavioural Sciences, Stanford University, California, USA
| | - Grace W K Ho
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong, People's Republic of China
| | - Boris Lorberg
- Department of Psychiatry, UMass Chan Medical School, Massachusetts, USA
| | - Dmytro Martsenkovskyi
- Department of Psychiatry and Narcology, Bogomolets National Medical University, Kyiv, Ukraine.,Institute of Psychiatry, Forensic Psychiatric Examination and Drug Monitoring of Ministry of Health of Ukraine, Kyiv, Ukraine
| | - Philip Hyland
- Department of Psychology, Maynooth University, Kildare, Ireland
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44
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Nolan E, Bunting L, McCartan C, Davidson G, Grant A, Schubotz D, Mulholland C, McBride O, Murphy J, Shevlin M. Prevalence of probable eating disorders and associated risk factors: An analysis of the Northern Ireland Youth Wellbeing Survey using the SCOFF. Br J Clin Psychol 2023; 62:180-195. [PMID: 36303442 PMCID: PMC10091957 DOI: 10.1111/bjc.12401] [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: 02/28/2022] [Accepted: 09/02/2022] [Indexed: 11/29/2022]
Abstract
OBJECTIVES Eating disorders (ED) are associated with significant morbidity and mortality rates and are most common in young people aged between 15 and 19 years. Large representative surveys on disordered eating in youth are lacking. The main aims were to estimate the prevalence of disordered eating in a representative sample of 11-19 year olds in Northern Ireland and investigate the associations between probable eating disorder and a range of risk factors. DESIGNS AND METHODS A large nationally representative household survey was conducted, and the bivariate and multivariate associations between demographic, familial, economic and psychological risk factors and probable eating disorder were assessed. RESULTS A total of 16.2% (n = 211) of the sample met the SCOFF screening criteria for disordered eating. Probable eating disorder was associated with being female (OR = 2.44), having a parent with mental health problems (OR = 1.68), suffering from certain psychological problems, such as mood or anxiety disorder (OR = 2.55), social media disorder (OR = 2.95), being the victim of physical bullying (OR = 1.71) and having smoked (OR = 2.46). CONCLUSIONS This study provides the first prevalence estimates of probable eating disorder among youth in Northern Ireland. Furthermore, the study identifies unique risk factors for probable eating disorder among this representative sample.
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45
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Shevlin M, Hyland P, Butter S, McBride O, Hartman TK, Karatzias T, Bentall RP. The development and initial validation of self-report measures of ICD-11 depressive episode and generalized anxiety disorder: The International Depression Questionnaire (IDQ) and the International Anxiety Questionnaire (IAQ). J Clin Psychol 2023; 79:854-870. [PMID: 36215152 PMCID: PMC10092474 DOI: 10.1002/jclp.23446] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [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: 05/16/2022] [Revised: 09/11/2022] [Accepted: 09/22/2022] [Indexed: 11/11/2022]
Abstract
BACKGROUND The new International Classification of Diseases came into effect in 2022 (ICD-11; World Health Organization, 2022) and included updated descriptions and diagnostic rules for "Depressive Episode" and "Generalized Anxiety Disorder." No self-report measures align with these disorders so this study reports the development and initial validation of the "International Depression Questionnaire" (IDQ) and "International Anxiety Questionnaire" (IAQ). METHODS Items were developed that aligned to the ICD-11 descriptions and their performance was assessed using data from a community sample (N = 2058) that was representative of the United Kingdom adult population. RESULTS Item response theory models indicated that the two scales were unidimensional, and the items performed well in terms of difficulty and discrimination. Estimates of internal reliability were high. Based on ICD-11 derived diagnostic algorithms, 7.4% met requirements for ICD-11 Depressive Episode and 7.1% for Generalized Anxiety Disorder. CONCLUSIONS The IDQ and the IAQ are short, easy to use, self-report measures aligned to the new and updated ICD-11 diagnostic descriptions. This study provides initial evidence that the scales produce scores that are reliable and valid.
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Affiliation(s)
- Mark Shevlin
- School of Psychology, Ulster University, Coleraine, Northern Ireland
| | - Philip Hyland
- Department of Psychology, Maynooth University, Maynooth, Ireland
| | - Sarah Butter
- School of Psychology, Ulster University, Coleraine, Northern Ireland
| | - Orla McBride
- School of Psychology, Ulster University, Coleraine, Northern Ireland
| | - Todd K Hartman
- Department of Social Statistics, University of Manchester, Manchester, England
| | - Thanos Karatzias
- School of Health & Social Care, Napier University, Edinburgh, Scotland
| | - Richard P Bentall
- Department of Psychology, University of Sheffield, Sheffield, England
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46
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Greenblatt-Kimron L, Karatzias T, Yonatan M, Shoham A, Hyland P, Ben-Ezra M, Shevlin M. Early maladaptive schemas and ICD-11 CPTSD symptoms: Treatment considerations. Psychol Psychother 2023; 96:117-128. [PMID: 36253922 DOI: 10.1111/papt.12429] [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] [Received: 08/06/2021] [Accepted: 09/19/2022] [Indexed: 11/30/2022]
Abstract
OBJECTIVES Early maladaptive schemas (EMS) can result from adverse interpersonal traumatic experiences. The ICD-11 updated the concept of disorders following traumatic experiences with the new disorder of complex post-traumatic stress disorder (CPTSD). There is now a need to develop and test interventions for CPTSD. An essential step in identifying interventions that are particularly relevant to the treatment of CPTSD is to explore psychological constructs associated more closely with CPTSD compared to PTSD. The current study explored the associations of EMS with PTSD and CPTSD. DESIGN The sample consisted of 603 adults (mean age = 41.65, SD = 13.8), recruited through social media and e-mails, and who responded to an online questionnaire. METHODS Participants completed measures of demographic, traumatic life events, EMS, PTSD and CPTSD symptoms. RESULTS Overall, results suggest that participants with CPTSD present with higher schema elevations across all schemas compared to those with PTSD or no diagnosis. Secondly, the schemas of emotional deprivation, abandonment/instability, social isolation/alienation, defectiveness/shame, enmeshment/undeveloped self, subjugation, emotional inhibition and insufficient self-control/self-discipline were significantly associated with the symptom clusters of CPTSD. Finally, results indicate that different schemas form significant associations with the individual symptom clusters of CPTSD. CONCLUSIONS Although results require replication in clinical samples, initial findings suggest that specific EMS may be important psychological correlates of CPTSD symptoms. Wider treatment considerations of these findings are discussed.
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Affiliation(s)
| | - Thanos Karatzias
- School of Health & Social Care, Edinburgh Napier University, Edinburgh, UK.,Rivers Centre for Traumatic Stress, NHS Lothian, Edinburgh, UK
| | - Maya Yonatan
- School of Social Work, Ariel University, Ariel, Israel
| | - Adi Shoham
- School of Social Work, Ariel University, Ariel, Israel
| | - Philip Hyland
- Department of Psychology, Maynooth University, Kildare, Ireland.,Trinity Centre for Global Health, University of Dublin, Trinity College, Dublin, Ireland
| | | | - Mark Shevlin
- School of Psychology, Ulster University, Coleraine, UK
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47
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Owczarek M, Karatzias T, McElroy E, Hyland P, Cloitre M, Kratzer L, Knefel M, Grandison G, Ho GWK, Morris D, Shevlin M. Borderline Personality Disorder (BPD) and Complex Posttraumatic Stress Disorder (CPTSD): A Network Analysis in a Highly Traumatized Clinical Sample. J Pers Disord 2023; 37:112-129. [PMID: 36723419 DOI: 10.1521/pedi.2023.37.1.112] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [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: 02/02/2023]
Abstract
Whether complex posttraumatic stress disorder (CPTSD) and borderline personality disorder (BPD) diagnoses differ substantially enough to warrant separate diagnostic classifications has been a subject of controversy for years. To contribute to the nomological network of cumulative evidence, the main goal of the present study was to explore, using network analysis, how the symptoms of ICD-11 PTSD and disturbances in self-organization (DSO) are interconnected with BPD in a clinical sample of polytraumatized individuals (N = 330). Participants completed measures of life events, CPTSD, and BPD. Overall, our study suggests that BPD and CPTSD are largely separated. The bridges between BPD and CPTSD symptom clusters were scarce, with "Affective Dysregulation" items being the only items related to BPD. The present study contributes to the growing literature on discriminant validity of CPTSD and supports its distinctiveness from BPD. Implications for treatment are discussed.
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Affiliation(s)
- Marcin Owczarek
- School of Psychology, Ulster University, Derry, Northern Ireland
| | - Thanos Karatzias
- Edinburgh Napier University, School of Health & Social Care, Edinburgh, UK.,NHS Lothian, Rivers Centre for Traumatic Stress, Edinburgh, UK
| | - Eoin McElroy
- Department of Neuroscience, Psychology and Behaviour, University of Leicester, Leicester, UK
| | - Philip Hyland
- Department of Psychology, Maynooth University, Kildare, Ireland
| | - Marylène Cloitre
- National Center for PTSD Dissemination and Training Division, VA Palo Alto Health Care System, Palo Alto, California.,Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, California
| | - Leonhard Kratzer
- Department of Psychotraumatology, Clinic St. Irmingard, Prien am Chiemsee, Germany
| | | | | | - Grace W K Ho
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong
| | - Deborah Morris
- Centre for Developmental and Complex Trauma St Andrews Healthcare, UK
| | - Mark Shevlin
- School of Psychology, Ulster University, Derry, Northern Ireland
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48
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Redican E, McBride O, Bunting L, Murphy J, Shevlin M. Prevalence and predictors of benevolent childhood experiences among a representative sample of young people. Br J Psychol 2023; 114:229-243. [PMID: 36351744 PMCID: PMC10100509 DOI: 10.1111/bjop.12607] [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: 05/25/2022] [Revised: 09/09/2022] [Accepted: 10/17/2022] [Indexed: 11/11/2022]
Abstract
Emerging research evidence suggests that benevolent childhood experiences (BCEs) may partly explain more favourable mental health outcomes among individuals affected by adverse childhood experiences (ACEs). However, much of this research has focused on adult populations. Consequently, this study sought to provide the first rigorous assessment of the prevalence and predictors of BCEs using a nationally representative sample of young people from Northern Ireland (NI). Participants were 11-19-years-olds (N = 1293) who participated in the NI Youth Wellbeing Prevalence Survey (NI-YWS, 2020). Prevalence rates, gender differences and predictors of BCEs were investigated. Results revealed how most of the sample experienced multiple BCEs (95%, n = 1084), with females reporting higher levels of BCEs. Significant positive predictors of BCEs were female gender, parental education, living with both biological parents, and living in areas with lower deprivation, while significant negative predictors of BCEs included family being in receipt of social welfare and older age. Overall, this study highlights how BCEs are common, while the identification of factors associated with likelihood of having positive experiences during early development provides novel insights into those young people who may be at greater risk for maladaptive psychological outcomes.
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Affiliation(s)
| | - Orla McBride
- School of Psychology, Ulster University, Coleraine, UK
| | | | - Jamie Murphy
- School of Psychology, Ulster University, Coleraine, UK
| | - Mark Shevlin
- School of Psychology, Ulster University, Coleraine, UK
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49
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Shevlin M, Butter S, McBride O, Murphy J, Gibson-Miller J, Hartman TK, Levita L, Mason L, Martinez AP, McKay R, Stocks TVA, Bennett K, Hyland P, Bentall RP. Refuting the myth of a 'tsunami' of mental ill-health in populations affected by COVID-19: evidence that response to the pandemic is heterogeneous, not homogeneous. Psychol Med 2023; 53:429-437. [PMID: 33875044 DOI: 10.31234/osf.io/ujwsm] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
BACKGROUND The current study argues that population prevalence estimates for mental health disorders, or changes in mean scores over time, may not adequately reflect the heterogeneity in mental health response to the COVID-19 pandemic within the population. METHODS The COVID-19 Psychological Research Consortium (C19PRC) Study is a longitudinal, nationally representative, online survey of UK adults. The current study analysed data from its first three waves of data collection: Wave 1 (March 2020, N = 2025), Wave 2 (April 2020, N = 1406) and Wave 3 (July 2020, N = 1166). Anxiety-depression was measured using the Patient Health Questionnaire Anxiety and Depression Scale (a composite measure of the PHQ-9 and GAD-7) and COVID-19-related posttraumatic stress disorder (PTSD) with the International Trauma Questionnaire. Changes in mental health outcomes were modelled across the three waves. Latent class growth analysis was used to identify subgroups of individuals with different trajectories of change in anxiety-depression and COVID-19 PTSD. Latent class membership was regressed on baseline characteristics. RESULTS Overall prevalence of anxiety-depression remained stable, while COVID-19 PTSD reduced between Waves 2 and 3. Heterogeneity in mental health response was found, and hypothesised classes reflecting (i) stability, (ii) improvement and (iii) deterioration in mental health were identified. Psychological factors were most likely to differentiate the improving, deteriorating and high-stable classes from the low-stable mental health trajectories. CONCLUSIONS A low-stable profile characterised by little-to-no psychological distress ('resilient' class) was the most common trajectory for both anxiety-depression and COVID-19 PTSD. Monitoring these trajectories is necessary moving forward, in particular for the ~30% of individuals with increasing anxiety-depression levels.
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Affiliation(s)
- Mark Shevlin
- School of Psychology, Ulster University, Derry, Northern Ireland
| | - Sarah Butter
- Department of Psychology, University of Sheffield, Sheffield, UK
| | - Orla McBride
- School of Psychology, Ulster University, Derry, Northern Ireland
| | - Jamie Murphy
- School of Psychology, Ulster University, Derry, Northern Ireland
| | | | - Todd K Hartman
- Sheffield Methods Institute, Department of Psychology, University of Sheffield, Sheffield, UK
| | - Liat Levita
- Department of Psychology, University of Sheffield, Sheffield, UK
| | - Liam Mason
- Division of Psychology and Language Sciences, University College London, London, UK
| | - Anton P Martinez
- Department of Psychology, University of Sheffield, Sheffield, UK
| | - Ryan McKay
- Department of Psychology, Royal Holloway, University of London, London, UK
| | | | - Kate Bennett
- Institute of Population Health, University of Liverpool, Liverpool, UK
| | - Philip Hyland
- Department of Psychology, Maynooth University, Maynooth, Republic of Ireland
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50
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Shevlin M, Butter S, McBride O, Murphy J, Gibson-Miller J, Hartman TK, Levita L, Mason L, Martinez AP, McKay R, Stocks TVA, Bennett K, Hyland P, Bentall RP. Refuting the myth of a 'tsunami' of mental ill-health in populations affected by COVID-19: evidence that response to the pandemic is heterogeneous, not homogeneous. Psychol Med 2023; 53:429-437. [PMID: 33875044 PMCID: PMC8111207 DOI: 10.1017/s0033291721001665] [Citation(s) in RCA: 60] [Impact Index Per Article: 60.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Revised: 04/14/2021] [Accepted: 04/14/2021] [Indexed: 12/20/2022]
Abstract
BACKGROUND The current study argues that population prevalence estimates for mental health disorders, or changes in mean scores over time, may not adequately reflect the heterogeneity in mental health response to the COVID-19 pandemic within the population. METHODS The COVID-19 Psychological Research Consortium (C19PRC) Study is a longitudinal, nationally representative, online survey of UK adults. The current study analysed data from its first three waves of data collection: Wave 1 (March 2020, N = 2025), Wave 2 (April 2020, N = 1406) and Wave 3 (July 2020, N = 1166). Anxiety-depression was measured using the Patient Health Questionnaire Anxiety and Depression Scale (a composite measure of the PHQ-9 and GAD-7) and COVID-19-related posttraumatic stress disorder (PTSD) with the International Trauma Questionnaire. Changes in mental health outcomes were modelled across the three waves. Latent class growth analysis was used to identify subgroups of individuals with different trajectories of change in anxiety-depression and COVID-19 PTSD. Latent class membership was regressed on baseline characteristics. RESULTS Overall prevalence of anxiety-depression remained stable, while COVID-19 PTSD reduced between Waves 2 and 3. Heterogeneity in mental health response was found, and hypothesised classes reflecting (i) stability, (ii) improvement and (iii) deterioration in mental health were identified. Psychological factors were most likely to differentiate the improving, deteriorating and high-stable classes from the low-stable mental health trajectories. CONCLUSIONS A low-stable profile characterised by little-to-no psychological distress ('resilient' class) was the most common trajectory for both anxiety-depression and COVID-19 PTSD. Monitoring these trajectories is necessary moving forward, in particular for the ~30% of individuals with increasing anxiety-depression levels.
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Affiliation(s)
- Mark Shevlin
- School of Psychology, Ulster University, Derry, Northern Ireland
| | - Sarah Butter
- Department of Psychology, University of Sheffield, Sheffield, UK
| | - Orla McBride
- School of Psychology, Ulster University, Derry, Northern Ireland
| | - Jamie Murphy
- School of Psychology, Ulster University, Derry, Northern Ireland
| | | | - Todd K. Hartman
- Sheffield Methods Institute, Department of Psychology, University of Sheffield, Sheffield, UK
| | - Liat Levita
- Department of Psychology, University of Sheffield, Sheffield, UK
| | - Liam Mason
- Division of Psychology and Language Sciences, University College London, London, UK
| | | | - Ryan McKay
- Department of Psychology, Royal Holloway, University of London, London, UK
| | | | - Kate Bennett
- Institute of Population Health, University of Liverpool, Liverpool, UK
| | - Philip Hyland
- Department of Psychology, Maynooth University, Maynooth, Republic of Ireland
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