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Muysewinkel E, Vesentini L, Van Deynse H, Vanclooster S, Bilsen J, Van Overmeire R. A day in the life: psychological impact on emergency responders during the 22 March 2016 terrorist attacks. Front Psychiatry 2024; 15:1353130. [PMID: 38410678 PMCID: PMC10894950 DOI: 10.3389/fpsyt.2024.1353130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2023] [Accepted: 01/19/2024] [Indexed: 02/28/2024] Open
Abstract
Introduction Terrorist attacks can cause severe long-term mental health issues that need treatment. However, in the case of emergency responders, research is often vague on the type of stressors that emergency responders encounter. For example, in addition to the threat that they work under, studies have shown that ill-preparation adds to the stress experienced by emergency responders. However, few studies have looked into the experience of emergency responders. In this study, we looked at the experience of emergency responders during the 22 March 2016 terrorist attacks in Belgium. Methods We used a qualitative design, in which we interviewed different types of emergency responders. Police officers, nurses, soldiers, firefighters, and Red Cross volunteers were included. Interviews were coded by two researchers and analyzed using a thematic approach. Results Four large themes were developed: constant threat and chaos, frustrations with lack of preparedness and training, ethical decisions, and debriefings. In addition, although emergency responders encountered constant threat, they often felt that they were ill-prepared for such attacks. One specific example was their lack of training in tourniquet usage. Furthermore, in a disaster setting, the emergency responders had to make life-and-death decisions for which they were not always prepared. Finally, debriefings were conducted in the aftermath of the attacks. Whereas most were perceived as positive, the debriefings among police officers were viewed as insufficient. Conclusions Emergency responding to terrorist attacks has many different dimensions of events that can cause stress. Our study revealed that preparation is key, not only in terms of material but also in terms of ethics and debriefings.
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Affiliation(s)
- Emilie Muysewinkel
- Mental Health and Wellbeing Research Group, Vrije Universiteit Brussel, Brussel, Belgium
- Department of Public Health, Vrije Universiteit Brussel, Brussel, Belgium
| | - Lara Vesentini
- Mental Health and Wellbeing Research Group, Vrije Universiteit Brussel, Brussel, Belgium
| | - Helena Van Deynse
- Department of Public Health, Vrije Universiteit Brussel, Brussel, Belgium
| | - Stephanie Vanclooster
- Mental Health and Wellbeing Research Group, Vrije Universiteit Brussel, Brussel, Belgium
| | - Johan Bilsen
- Mental Health and Wellbeing Research Group, Vrije Universiteit Brussel, Brussel, Belgium
| | - Roel Van Overmeire
- Mental Health and Wellbeing Research Group, Vrije Universiteit Brussel, Brussel, Belgium
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Akanni OO, Edeh AN, Agbir MT, Olashore AA. The quality of life and its inter-relationship with posttraumatic stress disorder and social support in two post-conflict communities in Nigeria. J Health Psychol 2024:13591053231222851. [PMID: 38254299 DOI: 10.1177/13591053231222851] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2024] Open
Abstract
The study aimed to compare the quality of life (QoL) in two communities with different exposures to conflict and investigate the inter-relationship between posttraumatic stress disorder (PTSD), social support, and QoL. This is a cross-sectional with 413 participants. Study instruments included the PTSD module of the Composite International Diagnostic Interview (CIDI), the World Health Organization Quality of Life BREF (WHOQoL-BREF), and the Multidimensional Scale of Perceived Social Support (MSPSS). The family domain of social support was protective of both PTSD and QoL. Except for the relationship between community's location and the physical subscale of the QoL, a hierarchical regression analysis showed that all the independent variables were significantly associated with the QoL domains. Direct exposure to crises impaired QoL more than areas indirectly exposed. PTSD and the family domain of social support play a significant role in the QoL outcome. This suggests that therapeutic intervention to improve QoL should target these key variables.
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McCollum DC, Teeters JB, Moskal KR, Woodward MJ. Does Social Support Moderate the Association between Adverse Childhood Experiences and Substance-Related Problems? Subst Use Misuse 2023; 59:269-277. [PMID: 37853713 DOI: 10.1080/10826084.2023.2269570] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2023]
Abstract
Background: More than half of individuals in the United States have had adverse childhood experiences (ACEs), which can result in physical and mental distress. ACEs has been linked with greater likelihood of harmful alcohol and drug use. Research has found that protective factors, such as social support, may potentially buffer against harmful substance use engagement among those who have experienced ACEs. The purpose of this study was to examine associations between perceived social support, ACEs, and alcohol and cannabis-related problems. Moreover, this study aimed to examine if specific domains of perceived social support (family, friends, and significant other) moderated the relationship between ACEs and alcohol and cannabis-related problems. Method: Validated measures of ACEs, perceived social support, and alcohol and cannabis problems were collected in a sample of 401 emerging adults via Prolific Academic (an online data collection platform). Results: Overall perceived social support and domains such as perceived family and friend social support moderated the relationship between ACEs and alcohol-related problems but not ACEs and cannabis-related problems. The association between ACEs and alcohol-related problems was strongest at low levels of perceived family and friend social support. Perceived social support was not associated with cannabis-related problems. Conclusions: Lack of social support is a potential risk factor for alcohol-related problems among emerging adults. Bolstering perceived social support from family and friends among those who have experienced ACEs may be beneficial in intervention and treatment efforts aiming to reduce harmful substance use in this population.
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Affiliation(s)
- Diamonde C McCollum
- Psychological Sciences Department, Western Kentucky University, Bowling Green, Kentucky, USA
| | - Jenni B Teeters
- Psychological Sciences Department, Western Kentucky University, Bowling Green, Kentucky, USA
| | - Katie R Moskal
- Psychological Sciences Department, Western Kentucky University, Bowling Green, Kentucky, USA
| | - Matthew J Woodward
- Psychological Sciences Department, Western Kentucky University, Bowling Green, Kentucky, USA
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Sorjonen K, Melin B. Prospective associations between social support and posttraumatic stress disorder may be spurious: A re-meta-analysis of longitudinal studies and a simulation. J Affect Disord 2023; 340:174-180. [PMID: 37557992 DOI: 10.1016/j.jad.2023.08.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Revised: 07/18/2023] [Accepted: 08/03/2023] [Indexed: 08/11/2023]
Abstract
A recent meta-analysis concluded to have found proof for both a social causation model, according to which social support protects against posttraumatic stress disorder (PTSD), and a social selection model, which claims that PTSD erodes social support. However, the prospective cross-lagged effects were estimated while adjusting for a prior measurement of the outcome and this method is vulnerable for spurious findings due to correlations with residuals and regression toward the mean. The present re-analyses of the meta-analytic effects indicated that depending on used model one can choose to claim that social support has either a decreasing, an increasing, or no prospective effect on subsequent change in PTSD symptom severity, and vice versa. Therefore, claims over and above a negative cross-sectional correlation between social support and PTSD, including the social causation and social selection models, can be questioned. The findings were validated by analyses of simulated data, which indicated that prospective effects were not necessary for the observed meta-analytic associations.
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Affiliation(s)
- Kimmo Sorjonen
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.
| | - Bo Melin
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
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Clapp JD, Sowers AF, Freng SA, Elmi LM, Kaya RA, Bachtel AR. Public beliefs about trauma and its consequences: Profiles and correlates of stigma. Front Psychol 2023; 13:992574. [PMID: 36687984 PMCID: PMC9846146 DOI: 10.3389/fpsyg.2022.992574] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Accepted: 12/05/2022] [Indexed: 01/05/2023] Open
Abstract
Public stereotypes about trauma exposure and its likely consequences have the potential to influence levels of support extended to survivors in the larger community. The current project sought to examine unique profiles of stereotype endorsement both within and across participants sampled from distinct populations. Trauma-related stereotypes involving symptom course, dangerousness, employability, social functioning, predictability, character, and treatment need were examined in undergraduate (N 1 = 404; N 2 = 502) and MTurk (N 3 = 364) samples. Sympathizing [low overall endorsement], Fearful [high overall endorsement], Pejorative [high endorsement + moralizing beliefs], Safety-Focused [intermediate endorsement + dangerousness], and Performance-Focused [intermediate endorsement + employability] groups were replicated in latent profile models across all samples. Stereotype profiles demonstrated hypothesized associations with general perspectives of mental illness although support for consistent relations with respondent characteristics (e.g., sex; personal exposure to trauma; reported exposure in friends/family) was limited. Data suggest that trauma stereotypes are endorsed at high frequencies in the general community and conform to systematic patterns of prejudice that may be overlooked in more global assessments of stigma.
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Williamson V, Murphy D, Greenberg N. Veterinary professionals' experiences of moral injury: A qualitative study. Vet Rec 2023; 192:e2181. [PMID: 36065613 DOI: 10.1002/vetr.2181] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Revised: 08/10/2022] [Accepted: 08/19/2022] [Indexed: 01/21/2023]
Abstract
BACKGROUND Exposure to potentially morally injurious events (PMIE) has been found to be associated with negative mental health outcomes. Veterinary professionals (VPs) often experience challenging workplace events, but whether they experience PMIEs and the impact of exposure on their wellbeing is poorly understood. The objective of the study was to explore UK VPs experiences of PMIEs, the impact of PMIEs on VPs' wellbeing and beliefs about factors that influence VPs' exposure to PMIEs. METHODS Ten VPs were recruited. Semi-structured interviews were carried out, and data were analysed using thematic analysis. RESULTS VPs were found to experience PMIEs, including transgressive acts of commission or omission (e.g., being involved in or witnessing convenience euthanasia) or betrayal by trusted colleagues (e.g., bullying). Experiences of PMIEs evoked considerable psychological distress, including guilt, shame and loss of confidence in one's abilities. Several risk factors for experiencing psychological distress following a PMIE were described. CONCLUSIONS This study provides some of the first evidence that VPs may be vulnerable to moral injury and illustrates the impact that PMIEs may have on VPs' wellbeing. LIMITATIONS Future studies are needed to design and evaluate effective pathways for the prevention of and intervention for VPs who experience moral injury.
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Affiliation(s)
- Victoria Williamson
- King's Centre for Military Health Research, Institute of Psychology, Psychiatry and Neuroscience, King's College London, London, UK
| | - Dominic Murphy
- King's Centre for Military Health Research, Institute of Psychology, Psychiatry and Neuroscience, King's College London, London, UK
- Research Department, Combat Stress, Leatherhead, UK
| | - Neil Greenberg
- King's Centre for Military Health Research, Institute of Psychology, Psychiatry and Neuroscience, King's College London, London, UK
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Wang K, Vélez Ortiz D, Colón L, Sun F, Falcón L. The moderating role of everyday discrimination on the association between post-traumatic stress and loneliness among older Puerto Ricans. Aging Ment Health 2022:1-8. [PMID: 36444946 DOI: 10.1080/13607863.2022.2149695] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/03/2022]
Abstract
OBJECTIVES This study examines the relationship between post-traumatic stress and loneliness and whether this relationship varies by perceived everyday discrimination among older Puerto Ricans. METHODS A total of 304 Puerto Ricans aged 60 and above from Wave 3 of the Boston Puerto Rican Health Study were included. Ordinary least squares regression examined the association between post-traumatic stress, perceived everyday discrimination, and loneliness. RESULTS Post-traumatic stress was significantly associated with a higher level of loneliness (β = 0.282; p < 0.001; 95% CI: 0.142, 0.423). The interaction effect between post-traumatic stress and perceived everyday discrimination on loneliness was statistically significant (β = 0.083; p < 0.05; 95% CI: 0.062, 0.230). More specifically, the positive association between post-traumatic stress and loneliness becomes more robust with the increase in perceived everyday discrimination. CONCLUSION Given an increase in population size on the U.S. mainland and migration from Puerto Rico due to natural disasters and declining economic conditions, it is essential to better understand the effect of perceived discrimination against older Puerto Ricans on the mainland United States as well as those who immigrated and stayed through older age. Outreach strategies and interventions that address perceived discrimination can help mitigate loneliness among older Puerto Ricans who experienced trauma.
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Affiliation(s)
- Kaipeng Wang
- Graduate School of Social Work, University of Denver, Denver, CO, USA
| | | | - Lisa Colón
- Department of Human Development, Washington State University, Pullman, WA, USA
| | - Fei Sun
- School of Social Work, Michigan State University, East Lansing, MI, USA
| | - Luis Falcón
- College of Fine Arts, Humanities and Social Sciences, University of Massachusetts Lowell, Lowell, MA, USA
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Hailemariam M, Zlotnick C, Taft A, Johnson JE. MOSAIC (MOthers’ AdvocateS In the Community) for pregnant women and mothers of children under 5 with experience of intimate partner violence: A pilot randomized trial study protocol. PLoS One 2022; 17:e0267679. [PMID: 35584181 PMCID: PMC9116623 DOI: 10.1371/journal.pone.0267679] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Accepted: 04/22/2022] [Indexed: 11/19/2022] Open
Abstract
Background Pregnancy and motherhood increase the risk for long-term exposure to physical, psychological and sexual intimate partner violence (IPV; sexual or physical violence by current or former partners). Pregnant women and mothers with children under 5 who have experienced IPV exhibit poor physical and mental health and obstetric outcomes. Depression and posttraumatic stress disorder (PTSD) are the two most common mental health consequences of IPV. There is good evidence that women with good social support have better mental health and IPV outcomes. Methods This study will develop MOthers’ AdvocateS In the Community (MOSAIC) Plus intervention for pregnant women and mothers with children under the age of 5. MOSAIC uses trained mentor mothers and has been found to reduce subsequent IPV. This study will blend the original MOSAIC intervention with principles of interpersonal psychotherapy (IPT) to address symptoms of depression, PTSD, and prevent subsequent risk of IPV. We will conduct a pilot randomized trial of the MOSAIC Plus intervention compared to the traditional MOSAIC intervention to determine its feasibility and acceptability. Study samples include focus groups (n = 36), open trial (n = 15), and a randomized pilot trial including 40 pregnant women and mothers with children under 5 who report current/recent of IPV and elevated symptoms of maternal depression and/or PTSD. The study’s primary outcome will be changes in maternal depressive and PTSD symptoms. Secondary outcomes will include reduction in subsequent IPV, improvement in functioning, changes in social support and effectiveness in obtaining resources. Discussion This is a formative study evaluating the feasibility and acceptability of a mentor mother intervention for pregnant women and mothers with children under 5. Promising results of this study will be used for a larger, fully-powered randomized trial evaluating the effectiveness of a mentor mother intervention in preventing subsequent IPV and reducing depressive and PTSD symptoms in this population.
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Affiliation(s)
- Maji Hailemariam
- Department of Obstetrics, Gynaecology and Reproductive Biology, Michigan State University, College of Human Medicine, East Lansing, MI, United States of America
- * E-mail:
| | - Caron Zlotnick
- Department of Psychiatry and Human Behavior, Brown University, Providence, RI, United States of America
- Department of Medicine at Women and Infants Hospital, Providence, RI, United States of America
- Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
| | - Angela Taft
- Judith Lumley Centre for Mother, Infant and Family Health Research, Latrobe University, Bundoora, Australia
| | - Jennifer E. Johnson
- Department of Obstetrics, Gynaecology and Reproductive Biology, Michigan State University, College of Human Medicine, East Lansing, MI, United States of America
- Division of Public Health, College of Human Medicine, Michigan State University, Flint, MI, United States of America
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Jittayuthd S, Karl A. Rejection sensitivity and vulnerable attachment: associations with social support and PTSD symptoms in trauma survivors. Eur J Psychotraumatol 2022; 13:2027676. [PMID: 35111286 PMCID: PMC8803066 DOI: 10.1080/20008198.2022.2027676] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Revised: 12/28/2021] [Accepted: 01/04/2022] [Indexed: 11/08/2022] Open
Abstract
Background Although social support has been consistently associated with recovery from psychological trauma and prevention of posttraumatic stress disorder (PTSD), individual differences in seeking or benefitting from social support in trauma survivors are not well understood. Factors associated with negative internal working models of self and others, emotion dysregulation, and interrupted bonds with an individual's social support groups such as vulnerable attachment and rejection sensitivity could contribute to lower experienced social support and higher levels of PTSD. Objective The objective of this study was to test a theoretically informed model and investigate how psychosocial variables such as vulnerable attachment styles, rejection sensitivity, and social support are associated with PTSD. Method Using a cross-sectional survey and path analyses in 141 survivors of trauma (aged 18-69, M = 25.20), the relationship between vulnerable attachment style, rejection sensitivity, and PTSD were investigated. Results Higher vulnerable attachment, rejection sensitivity, and lower social support were found to be significant predictors of PTSD symptoms (f2 = 0.75). The relationships from vulnerable attachment to PTSD were mediated by rejection sensitivity and perceived social support. The results supported and extend theoretical models of PTSD that posit a role for predisposing factors in the development and maintenance of the disorder. Conclusion The findings suggest a potential benefit of identifying vulnerable groups that could benefit from a refinement of existing PTSD interventions by targeting the maladaptive effects of vulnerable attachment and rejection sensitivity, thus allowing the individual to draw effectively on social support networks.
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Affiliation(s)
- Sila Jittayuthd
- Department of Psychology, College of Life and Environmental Sciences, University of Exeter, Exeter, UK
| | - Anke Karl
- Department of Psychology, College of Life and Environmental Sciences, University of Exeter, Exeter, UK
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Dodson TS, Beck JG. Using Social Support Matter in the Association of Post-Traumatic Cognitions and Perceived Social Support? Comparison of Female Survivors of Intimate Partner Violence With and Without a History of Child Abuse. JOURNAL OF INTERPERSONAL VIOLENCE 2021; 36:NP11674-NP11694. [PMID: 31771401 DOI: 10.1177/0886260519888529] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
The association between high levels of post-traumatic stress disorder (PTSD) symptoms and low levels of perceived social support is well-documented in the trauma literature; research on processes that may underlie this association is less common. The current study examined negative attitudes about using social support as a potential link between negative post-traumatic cognitions about the world and self, one aspect of PTSD, and perceived social support in two groups of female survivors of intimate partner violence: those who had a history of child abuse (n = 153; IPV/CA+) and those who did not (n = 96; IPV/CA-). Negative attitudes about using social support were found to be an important link between negative post-traumatic cognitions and social support for both groups. IPV survivors with a history of child abuse had higher levels of negative post-traumatic cognitions about the world (d = .32) and self (d = .33), greater negative attitudes about using social support (d = .35), and lower perceived social support from family (d = .48), compared with IPV survivors without a history of child abuse. These results support the relevance of negative attitudes about using social support as one important factor in the relationship between PTSD symptoms and social support in interpersonal trauma survivors and highlight the impact that negative attitudes about using social support can have on the trauma survivor's functioning.
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Brienza A, Suffoletto BP, Kuhn E, Germain A, Jaramillo S, Repine M, Callaway CW, Pacella-LaBarbara ML. The role of specific sources of social support on postinjury psychological symptoms. Rehabil Psychol 2021; 66:600-610. [PMID: 34398631 PMCID: PMC8648976 DOI: 10.1037/rep0000388] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
PURPOSE/OBJECTIVE The role of perceived social support from specific sources (e.g., families, friends, and significant others) on the development of postinjury posttraumatic stress disorder (PTSD) and associated psychological symptoms (e.g., depression and anxiety) remains relatively unexplored. We examined the predictive role of social support from specific sources on psychological symptoms among emergency department (ED) patients following motor vehicle crash (MVC). Research Methods/Design: Sixty-three injured patients (63.5% female; 37 years old on average) with moderately painful complaints were recruited in the EDs of two Level-1 trauma centers within 24 hr post-MVC. In the ED, participants completed surveys of baseline psychological symptoms and perceived social support; follow-up surveys were completed at 90 days postinjury. RESULTS Most of the sample (84.1%) was discharged home from the ED with predominantly mild injuries and did not require hospitalization. After adjusting for race, sex, age, and baseline symptoms, hierarchical regression analyses demonstrated that lower perceived social support in the ED predicted higher PTSD symptoms and depressive symptoms (but not anxiety) at 90 days. This effect seemed to be specific to significant others and friends but not family. CONCLUSIONS/IMPLICATIONS MVC-related injuries are robust contributors to psychological sequelae. These findings extend prior work by highlighting that perceived social support, particularly from significant others and friends, provides unique information regarding the development of psychological symptoms following predominantly mild MVC-related injuries. This data may serve to inform recovery expectations. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
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Van Overmeire R, Van Keer RL, Bilsen J. Impact of terrorist attacks on social relationships. Clin Psychol Psychother 2021; 28:1472-1481. [PMID: 33768615 DOI: 10.1002/cpp.2587] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2020] [Revised: 03/12/2021] [Accepted: 03/23/2021] [Indexed: 11/11/2022]
Abstract
BACKGROUND People that experience a trauma might also experience problems in their social relationships. However, how witnessing a terrorist attack influences social relationships is still understudied. This is important, as currently, there is more focus on the individual's mental health and not on how this mental health can impact the individual's social relations. In this study, the impact of the experience of a terrorist attack on social relationships was studied. METHODS In-depth interviews were conducted, with 31 directly exposed people during the 22 March 2016 attacks in Belgium. Data were analysed using reflexive thematic analysis. RESULTS Three factors related to the impact on social relationships were found. First, participants felt that they had changed. This includes feeling more aggressive, guilty, distrusting or psychosomatic factors, such as migraine attacks, which can hamper social visits. Second, the reactions of others on the participant's expressing their feelings and behaviour also caused participants to not feel understood by their social relationships. Third, due the first two factors, participants coped in different ways (e.g. remaining silent and avoiding certain triggers), which in turn caused their social relationships to change. CONCLUSIONS The social relationships of witnesses of terrorist attacks can be hampered due to both themselves as well as the reaction of others. More awareness seems to be needed on the possible mental health consequences of terrorist attacks for witnesses.
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Affiliation(s)
- Roel Van Overmeire
- Mental Health and Wellbeing Research Group (MENT), Vrije Universiteit Brussel, Brussels, Belgium
| | - Rose-Lima Van Keer
- Mental Health and Wellbeing Research Group (MENT), Vrije Universiteit Brussel, Brussels, Belgium
| | - Johan Bilsen
- Mental Health and Wellbeing Research Group (MENT), Vrije Universiteit Brussel, Brussels, Belgium
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13
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Minahan J, Falzarano F, Yazdani N, Siedlecki KL. The COVID-19 Pandemic and Psychosocial Outcomes Across Age Through the Stress and Coping Framework. THE GERONTOLOGIST 2021; 61:228-239. [PMID: 33320191 PMCID: PMC7799081 DOI: 10.1093/geront/gnaa205] [Citation(s) in RCA: 67] [Impact Index Per Article: 22.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2020] [Indexed: 12/28/2022] Open
Abstract
Background and Objectives The emergence of the Coronavirus Disease 2019 (COVID-19) and the measures implemented to curb its spread may have deleterious effects on mental health. Older adults may be at increased risk for adverse psychosocial outcomes because opportunities to remain socially connected have diminished. Research is needed to better understand the impact of pandemic-related stress on mental health. The purpose of this study is 3-fold: (a) to examine the influences of COVID-19 pandemic-related stress on depression, anxiety, and loneliness; (b) to assess the mediating role of coping style and social support; and (c) to investigate whether these relationships vary across age. Research Design and Methods Participants (N = 1,318) aged 18–92 years completed an online survey assessing pandemic-related stress, mental health, social support, coping, and their experiences with social distancing, during the initial implementation of social distancing measures in the United States. Results Social support and coping style were found to relate to psychosocial outcomes. Avoidant coping was the strongest mediator of the relationship between pandemic-related stress and psychosocial outcomes, particularly depression. Avoidant coping more strongly mediated the relationship between stress and depression in younger adults compared to older adults. Discussion and Implications Results were consistent with the stress and coping framework and recent work highlighting older adults’ resilience during the COVID-19 pandemic. Findings highlight the associations between positive coping behaviors and psychosocial well-being and indicate that older adults may use unique adaptive mechanisms to preserve well-being during the COVID-19 pandemic.
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Affiliation(s)
- Jillian Minahan
- Department of Psychology, Fordham University, Bronx, New York, USA
- Address correspondence to: Jillian Minahan, MA, Psychology Department, Fordham University, Dealy Hall 226, 441 E. Fordham Road, Bronx, NY 10458, USA. E-mail:
| | - Francesca Falzarano
- Division of Geriatrics and Palliative Medicine, Weill Cornell Medicine, New York, New York, USA
| | - Neshat Yazdani
- Department of Psychology, Fordham University, Bronx, New York, USA
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Zalta AK, Tirone V, Orlowska D, Blais RK, Lofgreen A, Klassen B, Held P, Stevens NR, Adkins E, Dent AL. Examining moderators of the relationship between social support and self-reported PTSD symptoms: A meta-analysis. Psychol Bull 2021; 147:33-54. [PMID: 33271023 PMCID: PMC8101258 DOI: 10.1037/bul0000316] [Citation(s) in RCA: 61] [Impact Index Per Article: 20.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Social support is one of the most robust predictors of posttraumatic stress disorder (PTSD). Yet, little is known about factors that moderate the relationship between social support and PTSD symptom severity. This meta-analysis estimated the overall effect size of the relationship between self-reported social support and PTSD severity and tested meaningful demographic, social support, and trauma characteristics that may moderate this association using both cross-sectional and longitudinal effect sizes. A comprehensive search identified 139 studies with 145 independent cross-sectional effect sizes representing 62,803 individuals and 37 studies with 38 independent longitudinal effect sizes representing 25,792 individuals. Study samples had to comprise trauma-exposed, nonclinical adult populations to be included in the analysis. Cross-sectional and longitudinal analyses revealed a near medium overall effect size (rcross = -.27; 95% CI [-.30, -.24]; rlong = -.25; 95% CI [-.28, -.21]) with a high degree of heterogeneity (cross-sectional I2 = 91.6, longitudinal I2 = 86.5). Both cross-sectional and longitudinal moderator analyses revealed that study samples exposed to natural disasters had a weaker effect size than samples exposed to other trauma types (e.g., combat, interpersonal violence), studies measuring negative social reactions had a larger effect size than studies assessing other types of social support, and veteran samples revealed larger effect sizes than civilian samples. Several other methodological and substantive moderators emerged that revealed a complex relationship between social support and PTSD severity. These findings have important clinical implications for the types of social support interventions that could mitigate PTSD severity. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
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Affiliation(s)
- Alyson K. Zalta
- Department of Psychological Science, University of California, Irvine, Irvine, CA
- Department of Psychiatry & Behavioral Sciences, Rush University Medical Center, Chicago, IL
| | - Vanessa Tirone
- Department of Psychiatry & Behavioral Sciences, Rush University Medical Center, Chicago, IL
| | - Daria Orlowska
- University Libraries, Western Michigan University, Kalamazoo, MI
| | | | - Ashton Lofgreen
- Department of Psychiatry & Behavioral Sciences, Rush University Medical Center, Chicago, IL
| | - Brian Klassen
- Department of Psychiatry & Behavioral Sciences, Rush University Medical Center, Chicago, IL
| | - Philip Held
- Department of Psychiatry & Behavioral Sciences, Rush University Medical Center, Chicago, IL
| | - Natalie R. Stevens
- Department of Psychiatry & Behavioral Sciences, Rush University Medical Center, Chicago, IL
| | - Elizabeth Adkins
- Department of Preventive Medicine, Northwestern University, Chicago, IL
| | - Amy L. Dent
- Department of Psychological Science, University of California, Irvine, Irvine, CA
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Nilaweera D, Freak-Poli R, Ritchie K, Chaudieu I, Ancelin ML, Ryan J. The long-term consequences of trauma and posttraumatic stress disorder symptoms on later life cognitive function and dementia risk. Psychiatry Res 2020; 294:113506. [PMID: 33075651 DOI: 10.1016/j.psychres.2020.113506] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Accepted: 10/07/2020] [Indexed: 01/15/2023]
Abstract
Stress may be a risk factor for dementia, however it is unknown whether post-traumatic stress disorder (PTSD) symptoms are associated with incident dementia in community-dwelling older individuals. The aim was to determine whether lifetime major trauma with and without re-experiencing of PTSD symptoms is associated with later-life cognition and dementia risk. Participants were 1,700 community-dwelling older adults (65+) in the longitudinal ESPRIT study followed over 14 years. Lifetime major traumatic exposure and PTSD were assessed using Watson's PTSD Inventory. Cognitive tests assessed global cognition, visual memory, verbal fluency, psychomotor speed and executive function. Incident dementia was diagnosed according to DSM-IV criteria. Lifetime major trauma (versus no trauma) was associated with significantly increased executive function and increased global function in men, however women with lifetime trauma and re-experiencing symptoms had a significantly increased risk of low global cognition. Over 14 years, lifetime trauma without re-experiencing symptoms was associated with a significantly decreased risk of incident dementia, particularly for women. Lifetime major trauma without re-experiencing symptoms (but not with) may be protective for later life cognitive function. However, the mechanisms and moderating factors underlying these association requires further investigation.
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Affiliation(s)
- Dinuli Nilaweera
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Rosanne Freak-Poli
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Karen Ritchie
- PSNREC, Univ Montpellier, INSERM, Montpellier, France; Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK
| | | | | | - Joanne Ryan
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia; PSNREC, Univ Montpellier, INSERM, Montpellier, France.
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Steine IM, Winje D, Krystal JH, Milde AM, Bjorvatn B, Nordhus IH, Grønli J, Pallesen S. Longitudinal Relationships between Perceived Social Support and Symptom Outcomes: Findings from a sample of Adult Survivors of Childhood Sexual Abuse. CHILD ABUSE & NEGLECT 2020; 107:104566. [PMID: 32526550 DOI: 10.1016/j.chiabu.2020.104566] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/22/2020] [Revised: 05/12/2020] [Accepted: 05/25/2020] [Indexed: 06/11/2023]
Abstract
INTRODUCTION Cross-sectional studies have consistently reported an inverse association between perceived social support and the severity of mental health symptoms among adult survivors of childhood sexual abuse (CSA). However, there is a lack of longitudinal studies investigating the bidirectional association between social support and the severity of symptoms among adult CSA-survivors, as well as the role of relational problems in predicting perceived social support and symptom levels over time. The present study addressed these questions in a sample of primarily female CSA-survivors. METHODS In a three-wave, four-year longitudinal study of 506 CSA-survivors (94.9% women, 5.1% men) recruited from support centers for sexual abuse survivors in Norway, we used cross-lagged panel structural equation modeling to examine the directionality of the longitudinal associations between perceived social support and symptoms of posttraumatic stress, anxiety, depression and insomnia. RESULTS Cross-lagged panel analyses revealed significant weak reciprocal associations between perceived social support and depression, posttraumatic stress symptoms and anxiety symptoms, but not with insomnia symptoms. The observed effects were partly overlapping and partly inconsistent across the different symptom domains. Relational problems predicted social support cross-sectionally and longitudinally, whereas only cross-sectional associations were found between the relational problems variable and mental health symptoms. Theoretical and clinical implications of the findings are discussed, alongside methodological limitations of the study.
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Affiliation(s)
- Iris M Steine
- UC Berkeley, Department of Psychology, 2121 Berkeley Way, Berkeley, CA 94704, USA; Department of Psychosocial Science, University of Bergen, Christiesgate 12, 5015 Bergen, Norway.
| | - Dagfinn Winje
- Department of Clinical Psychology, University of Bergen, Christiesgate 12, 5015 Bergen, Norway
| | - John H Krystal
- Clinical Neuroscience Division, VA National Center for PTSD, 950 Campbell Avenue, West Haven, CT 06516, USA; Department of Psychiatry, Yale University School of Medicine, 300 George Street, Suite 901, New Haven, CT 06511, USA
| | - Anne Marita Milde
- NORCE AS - Regional Centre for Child and Youth Mental Health and Child Welfare, Postbox 7810, 5020 Bergen, Norway; Department of Biological and Medical Psychology, University of Bergen, Jonas Lies vei 91, 5009 Bergen, Norway
| | - Bjørn Bjorvatn
- Department of Global Public Health and Primary Health Care, University of Bergen, Kalfarveien 31, 5018 Bergen, Norway; Norwegian Competence Center of Sleep Disorders, Haukeland University Hospital, PO Box 1400, 5021 Bergen, Norway
| | - Inger Hilde Nordhus
- Department of Clinical Psychology, University of Bergen, Christiesgate 12, 5015 Bergen, Norway; Institute of Basic Medical Sciences, University of Oslo, PO Box 1110, Blindern, 0317 Oslo, Norway
| | - Janne Grønli
- Department of Biological and Medical Psychology, University of Bergen, Jonas Lies vei 91, 5009 Bergen, Norway
| | - Ståle Pallesen
- Department of Psychosocial Science, University of Bergen, Christiesgate 12, 5015 Bergen, Norway; Norwegian Competence Center of Sleep Disorders, Haukeland University Hospital, PO Box 1400, 5021 Bergen, Norway
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Fredette C, Rizkallah E, El-Baalbaki G, Palardy V, Guay S. A qualitative analysis of the quality of social and marital support for PTSD victims. EUROPEAN JOURNAL OF TRAUMA & DISSOCIATION 2020. [DOI: 10.1016/j.ejtd.2019.100134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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A Scoping Review and Conceptual Model of Social Participation and Mental Health among Refugees and Asylum Seekers. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16204027. [PMID: 31640210 PMCID: PMC6843961 DOI: 10.3390/ijerph16204027] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/28/2019] [Revised: 10/15/2019] [Accepted: 10/16/2019] [Indexed: 11/17/2022]
Abstract
Social participation plays a key role in the integration of refugees and asylum seekers into their host societies, and is also closely tied to the mental health of those populations. The aim of this scoping review was to study how the concept of social participation is described in empirical research, and how it is associated with mental health outcomes. METHODS In total, 64 studies were identified through searches in PubMed, PsycInfo, and Sociological Abstracts. These studies describe various forms of social participation among refugees and asylum seekers, and 33 of them also addressed various forms of mental health outcomes. RESULTS The identified studies described forms and conditions of social participation-both in the host country and transnationally-that could be synthesized into three broad dimensions: (1) Regulatory frameworks, conditions and initiatives; (2) Established societal organizations and social structures; and (3) Community organized groups. Each of these consisted of several sub-domains. The identified dimensions of social participation were also associated with psychosocial well-being and decreased psychological distress. CONCLUSIONS There is a need for policies to enable and support the participation of refugees and asylum seekers in various dimensions of social structures in host societies. Social participation enhances resilience, re-establishes social lives, and acts as a protective factor against poor mental health outcomes.
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Gottvall M, Vaez M, Saboonchi F. Social support attenuates the link between torture exposure and post-traumatic stress disorder among male and female Syrian refugees in Sweden. BMC INTERNATIONAL HEALTH AND HUMAN RIGHTS 2019; 19:28. [PMID: 31488136 PMCID: PMC6727543 DOI: 10.1186/s12914-019-0214-6] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/28/2018] [Accepted: 08/29/2019] [Indexed: 01/03/2023]
Abstract
BACKGROUND The aim of this study is threefold: (i) to establish the psychometric properties and gender invariance of ENRICHD Social Support Inventory (ESSI), which was used for the first time in the present study in the population of Syrian refugees resettled in Sweden; (ii) to assess whether gender moderates the associations between social support, exposure to torture and PTSD; (iii) to assess whether social support mediates the association between exposure to torture and PTSD, and whether this mediation is in turn moderated by gender. METHODS Data from a cross-sectional and population-based study of a random sample of Syrian refugees (n = 1215) resettled in Sweden 2011-2013 was analyzed within a Structural Equation Modeling (SEM) framework. RESULTS Our results indicate adequate fit and gender invariance for a unidimensional model of ESSI. Exposure to torture was associated with lower social support (B = -0.22, p < 0.01) and with higher odds ratio (OR) for PTSD (OR 2.52, 95% Confidence interval (CI) 1.83-3.40). Furthermore, higher social support was associated with less likelihood for PTSD (B = -0.56, p < 0.001). Social support partially mediated the effect of torture exposure on PTSD (OR 1.13, 95% bias corrected bootstrap CI 1.06-1.26). Gender did not moderate this pattern. CONCLUSION The results indicate that social support attenuates the link between torture exposure and PTSD, and may function as a protective factor for PTSD among both torture-exposed refugee men and women.
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Affiliation(s)
- Maria Gottvall
- Department of Health Sciences, The Swedish Red Cross University College, PO Box 1059, SE-141 21 Huddinge, Sweden
- Clinical Psychology in Health Care, Department of Women’s and Children’s Health, Uppsala University, Akademiska sjukhuset, SE-751 85, Uppsala, Sweden
| | - Marjan Vaez
- Department of Health Sciences, The Swedish Red Cross University College, PO Box 1059, SE-141 21 Huddinge, Sweden
- Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, SE-171 77, Stockholm, Sweden
| | - Fredrik Saboonchi
- Department of Health Sciences, The Swedish Red Cross University College, PO Box 1059, SE-141 21 Huddinge, Sweden
- Division of Insurance Medicine, Department of Clinical Neuroscience, Karolinska Institutet, SE-171 77, Stockholm, Sweden
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van der Velden PG, Oudejans M, Das M, Bosmans MWG, Maercker A. The longitudinal effect of social recognition on PTSD symptomatology and vice versa: Evidence from a population-based study. Psychiatry Res 2019; 279:287-294. [PMID: 31262536 DOI: 10.1016/j.psychres.2019.05.044] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2019] [Revised: 05/30/2019] [Accepted: 05/31/2019] [Indexed: 01/20/2023]
Abstract
A specific type of social support after potentially traumatic events is called "social recognition". It is the acknowledgement or validation of event-related thoughts, behavior, and feelings by the individual or others. It consists of positive individual or societal reactions that recognize and acknowledge victims' traumatic experiences and difficulties. Current studies suggest that social recognition protects against the development of PTSD symptomatology, but there is a lack of population-based studies assessing the longitudinal interplay between PTSD symptomatology and social recognition. For this purpose, we conducted a longitudinal study using the Dutch LISS panel, based on a random sample of the Dutch population. Structural equation modeling showed that among recently affected adults (0-2 months ago), those with relatively higher levels of social recognition had lower levels of PTSD symptomatology 6 months later. Victims with high levels of PTSD symptomatology at baseline received less social recognition 6 months later. On the intermediate term (affected 5-12 months ago), baseline social recognition was no longer predictive of PTSD symptoms 6 months later, in contrast to PTSD symptomatology predicting lack of social recognition. In sum, PTSD symptom levels eroded social recognition on the short and intermediate term, while the protective role of social recognition was limited to the short term.
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Affiliation(s)
- Peter G van der Velden
- CentERdata and Tilburg University's Network on Health and Behavior (Nethlab), Tilburg, the Netherlands.
| | | | - Marcel Das
- CentERdata and Tilburg University's Network on Health and Behavior (Nethlab), Tilburg, the Netherlands
| | - Mark W G Bosmans
- Netherlands Institute for Health Services Research (NIVEL), Utrecht, the Netherlands
| | - Andreas Maercker
- Department of Psychology Psychopathology and Clinical Intervention, University of Zurich, Switzerland
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21
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Cox DW, Baugh LM, McCloskey KD, Iyar M. Social causation or social erosion? Evaluating the association between social support and PTSD among Veterans in a transition program. JOURNAL OF MILITARY VETERAN AND FAMILY HEALTH 2019. [DOI: 10.3138/jmvfh.2017-0040] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Introduction: Social support’s association with posttraumatic stress disorder (PTSD) in Veterans is well established. One explanation for this link is social causation – support inhibits PTSD. Inversely, within the social erosion model, PTSD erodes support. The aim of the present study was to examine if the social causation or social erosion model better explained the association between support and PTSD within a psychosocial intervention context. Methods: Veterans ( N = 218) participating in a multimodal transition program were assessed pre-program, post-program, and at 3-month follow-up on their perceived social support and PTSD symptoms. We used path analysis to conduct a three-wave cross-lagged panel model to compare the social erosion and social causation models. Results: PTSD symptoms were associated with attenuated improvements in social support, while social support was not associated with increased reductions in PTSD symptoms. This association was observed from pre- to post-program and from post-program to follow-up. Discussion: These findings support the social erosion model over the social causation model. Clinical implications of PTSD inhibiting interpersonal gains are discussed.
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Affiliation(s)
- Daniel W. Cox
- Counselling Psychology Program, University of British Columbia, Vancouver, British Columbia, Canada
| | - Leah M. Baugh
- Counselling Psychology Program, University of British Columbia, Vancouver, British Columbia, Canada
| | - Katherine D. McCloskey
- Counselling Psychology Program, University of British Columbia, Vancouver, British Columbia, Canada
| | - Megumi Iyar
- Counselling Psychology Program, University of British Columbia, Vancouver, British Columbia, Canada
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Nilsson H, Saboonchi F, Gustavsson C, Malm A, Gottvall M. Trauma-afflicted refugees' experiences of participating in physical activity and exercise treatment: a qualitative study based on focus group discussions. Eur J Psychotraumatol 2019; 10:1699327. [PMID: 31853335 PMCID: PMC6913663 DOI: 10.1080/20008198.2019.1699327] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2019] [Revised: 11/18/2019] [Accepted: 11/19/2019] [Indexed: 12/30/2022] Open
Abstract
Background: Refugees with prolonged and repeated experiences of trauma, often in combination with post-migration living difficulties, are subjected to severe levels of stress and stress-related ill health, including post-traumatic stress disorder (PTSD). Physical activity (PA) is well-established as an effective stress reliever. However, the effect of PA and exercise has received scarce attention in the context of PTSD, and particularly in the field of refugees' health. Objective: The objective of this study was to explore the experience of participation in PA and exercise as part of the treatment for trauma-afflicted refugees. Method: An explorative qualitative research design was used. Six focus group discussions were conducted with 33 female and male participants that had experience of group-based PA and exercise treatment. The gathered data was analysed by qualitative content analysis. Results: The analysis resulted in one over-arching theme reflecting the participants overall experience of PA and exercise as a process of building resilience. Participants experienced improvements in both physical and mental health domains. Increased self-awareness and self-confidence were seen as additional important benefits, and the interruption of daily stressors provided a sense of relief and recovery. The treatment group settings were experienced as becoming a vehicle for overcoming social fear and isolation, which also carried an empowering and strength-building impact over to participants' family life and social relationships. Treatment characteristics were experienced as highly supportive and often referred to as the basis of other positive experiences and perceived health benefits. Conclusions: The result of this study outlines a detailed account of trauma-afflicted refugees' experiences and preferences of PA and exercise-based treatment from a broad range of perspectives. These findings provide a starting point for future research in this field and indicate a particular need for both research and intervention development to include the real-life impact of participating in such treatments.
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Affiliation(s)
- Henrik Nilsson
- Department of Health Sciences, The Swedish Red Cross University College, Huddinge, Sweden.,Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.,The Swedish Red Cross Treatment Center for Persons Affected by War and Torture, Malmö, Sweden
| | - Fredrik Saboonchi
- Department of Health Sciences, The Swedish Red Cross University College, Huddinge, Sweden.,Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Catharina Gustavsson
- Department of Health Sciences, The Swedish Red Cross University College, Huddinge, Sweden.,Center for Clinical Research Dalarna, Uppsala University, Falun, Sweden
| | - Andreas Malm
- Department of Health Sciences, The Swedish Red Cross University College, Huddinge, Sweden.,Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.,The Swedish Red Cross Treatment Center for Persons Affected by War and Torture, Malmö, Sweden
| | - Maria Gottvall
- Department of Health Sciences, The Swedish Red Cross University College, Huddinge, Sweden.,Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
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Thoresen S, Birkeland MS, Arnberg FK, Wentzel-Larsen T, Blix I. Long-term mental health and social support in victims of disaster: comparison with a general population sample. BJPsych Open 2019; 5:e2. [PMID: 30762498 PMCID: PMC6343115 DOI: 10.1192/bjo.2018.74] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Trauma and traumatic bereavement have well-known consequences for mental health, but little is known about long-term adjustment, particularly with respect to health-protective factors.AimsTo assess the levels of anxiety/depression and perceived social support among the survivors and the bereaved 26 years after the Scandinavian Star ferry disaster compared with expected levels from the general population. METHOD Anxiety/depression and social support were assessed in face-to-face interviews with the survivors and the bereaved (N = 165, response rate 58%). Expected scores were calculated for each participant based on the means and proportions for each age and gender combination from a general population sample. We computed the ratio between expected and observed scores, standardised mean differences with 95% confidence intervals and standardised effect sizes. RESULTS We found an elevated level of anxiety/depression symptoms in the victims (Mdiff = 0.28, 95% CI 0.18, 0.38; effect size 0.43, 95% CI 0.31, 0.55) and a significant excess of individuals with a clinically significant level of symptoms. The observed level of perceived social support was significantly lower than that expected (Mdiff = -0.57, 95% CI -0.70, -0.44; effect size -0.73, 95% CI -0.89, -0.57). This was the case for both survivors and those who were bereaved and for both men and women. CONCLUSIONS This study reveals that disaster survivors and the bereaved reported elevated levels of anxiety and depression symptoms 26 years after the event. They also reported a markedly reduced level of social support. Traumas and post-traumatic responses may thus cause lasting harm to interpersonal relationships.Declaration of interestNone.
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Affiliation(s)
- Siri Thoresen
- Research Professor,Norwegian Centre for Violence and Traumatic Stress Studies,Norway
| | | | - Filip K Arnberg
- Associate Professor,National Centre for Disaster Psychiatry,Department of Neuroscience,Psychiatry,Uppsala University,Sweden
| | - Tore Wentzel-Larsen
- Senior Researcher,Norwegian Centre for Violence and Traumatic Stress Studies,Norway and Centre for Child and Adolescent Mental Health,Norway
| | - Ines Blix
- Senior Researcher,Norwegian Centre for Violence and Traumatic Stress Studies,Norway
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The role of disclosure attitudes in the relationship between posttraumatic stress disorder symptom severity and perceived social support among emergency service workers. Psychiatry Res 2018; 270:602-610. [PMID: 30384278 DOI: 10.1016/j.psychres.2018.10.049] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2018] [Revised: 10/10/2018] [Accepted: 10/20/2018] [Indexed: 11/22/2022]
Abstract
The social-interpersonal framework model of posttraumatic stress disorder (PTSD; Maercker and Horn, 2012) highlights the relevance of interpersonal factors in the development and maintenance of PTSD symptoms. Therefore, the present study examined the role of self-perceived disclosure abilities to elucidate the well-known link between PTSD symptom severity and social support. In a cross-sectional design, 131 emergency service workers completed the Impact of Event Scale (IES-R), the Disclosure of Trauma Questionnaire (DTQ) and the Social Acknowledgement Questionnaire (SAQ) as well as answering trauma-specific questions to provide in-depth information regarding their experiences in potentially traumatic incidents and subsequent social interactions. We reveal the predescribed association between PTSD symptom severity and social support. However, bootstrap mediation analyses reveal the self-referential perceptions of disclosure abilities, particularly a reluctance to talk, to fully account for the link between PTSD symptom severity and social acknowledgement. Our findings strongly support the relevance of the self-perceived disclosure abilities in the processing of traumatic events. A reluctance to speak is associated with more severe PTSD symptoms and with lower levels of social support; therefore, facilitating and encouraging disclosure in individuals who feel unable to disclose traumatic contents may be clinically relevant in preventing feelings of social disapproval and isolation.
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25
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Kern SM, Stacy SE, Kozina RM, Ripley AJ, Clapp JD. Exploring the relation between posttraumatic stress disorder and interpersonal outcomes: The role of social acknowledgment and trauma type. J Clin Psychol 2018; 75:132-145. [PMID: 30395693 DOI: 10.1002/jclp.22693] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
OBJECTIVES Research demonstrates consistent relations between posttrauma symptoms and interpersonal dysfunction. The current study examined the extent to which perceptions of community rejection account for the relation between posttraumatic stress disorder (PTSD) and interpersonal outcomes in students exposed to assaultive and nonassaultive trauma. METHOD Participants (N = 137; 66.4% female; M = 20 years) completed a trauma history interview, questionnaires assessing symptom severity, social disapproval, and interpersonal outcomes. RESULTS Assault survivors (n = 83) reported greater symptoms (d = 0.57), disapproval (d = 0.80), and social impairment (d = 0.51) relative to the nonassault group (n = 54). However, regression analyses indicated stronger associations between PTSD and community disapproval in survivors of nonassaultive (β = 0.69; p < 0.001) versus assaultive (β = 0.34; p < 0.001) events. Indirect effects of PTSD on perceived support and interpersonal functioning through social disapproval were also larger for nonassaultive versus assaultive groups (p < 0.05). CONCLUSION Despite greater dysfunction among assault survivors, perceptions of disapproval may be a more salient factor for interpersonal dynamics following nonassaultive trauma.
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Affiliation(s)
- Shira M Kern
- Department of Psychology, University of Wyoming, Laramie, Wyoming
| | | | - Ryan M Kozina
- Department of Psychology, University of Wyoming, Laramie, Wyoming
| | - Adam J Ripley
- Department of Psychology, University of Wyoming, Laramie, Wyoming
| | - Joshua D Clapp
- Department of Psychology, University of Wyoming, Laramie, Wyoming
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Olashore AA, Akanni OO, Molebatsi K, Ogunjumo JA. Post-traumatic stress disorder among the staff of a mental health hospital: Prevalence and risk factors. S Afr J Psychiatr 2018; 24:1222. [PMID: 30263227 PMCID: PMC6138173 DOI: 10.4102/sajpsychiatry.v24i0.1222] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2018] [Accepted: 07/12/2018] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Mental health service providers are frequently exposed to stress and violence in the line of duty. There is a dearth of data concerning the psychological sequelae of the frequent exposure to stress and violence, especially among those who work in resource-limited countries such as Botswana. AIM To determine the prevalence and predictors of post-traumatic stress disorder (PTSD) among mental health workers in a tertiary mental health institute in Botswana. SETTING The study was conducted in Sbrana Psychiatric Hospital, which is the only referral psychiatric hospital in Botswana. METHODS The study used a descriptive cross-sectional design. A total of 201 mental health workers completed a researcher-designed psycho-socio-demographic questionnaire, which included one neuroticism item of the Big Five Inventory, and a PTSD Checklist-Civilian Version (PCL-C), which was used to assess symptoms of PTSD. RESULTS Majority of the study participants were general nurses (n = 121, 60.5%) and females (n = 122, 60.7%). Thirty-seven (18.4%) of the participants met the criteria for PTSD. Exposure to violence in the past 12 months (AOR = 3.26; 95% CI: 1.49-7.16) and high neuroticism score (AOR = 2.72; 95% CI: 1.19-6.24) were significantly associated with the diagnosis of PTSD among the participants. CONCLUSION Post-traumatic stress disorder could result from stressful events encountered in the course of managing patients in mental health institutes and departments. Pre-placement personality evaluation of health workers to be assigned to work in psychiatric units and post-incident trauma counselling of those exposed to violence may be beneficial in reducing the occurrence of PTSD in mental hospital health care workers.
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Affiliation(s)
| | - Oluyemi O Akanni
- Clinical Services, Federal Neuropsychiatric Hospital, Benin, Nigeria
| | | | - John A Ogunjumo
- Department of Family Medicine, University of Botswana, Botswana
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Association of Posttraumatic Stress Symptom Severity With Health-Related Quality of Life and Self-Reported Functioning Across 12 Months After Severe Traumatic Brain Injury. Arch Phys Med Rehabil 2018; 99:1576-1583. [DOI: 10.1016/j.apmr.2018.02.008] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2017] [Revised: 02/05/2018] [Accepted: 02/10/2018] [Indexed: 11/15/2022]
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Boykin DM, Orcutt HK. Treatment Use Among College Women Following a Campus Shooting. JOURNAL OF AGGRESSION, MALTREATMENT & TRAUMA 2018; 28:261-280. [PMID: 31467476 PMCID: PMC6715303 DOI: 10.1080/10926771.2018.1480548] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/15/2017] [Revised: 04/20/2018] [Accepted: 05/21/2018] [Indexed: 06/10/2023]
Abstract
Despite increases in campus shootings, there is limited research on treatment utilization after these tragic events. The present study prospectively examined the prevalence and predictors of treatment use among college women following a campus shooting. Predictors included age, race/ethnicity, education level, severity of exposure to shooting, and post-shooting sequelae (i.e., social support, posttraumatic stress disorder [PTSD] severity, depression severity). Present data were obtained from 516 women on campus at the time of the shooting. They completed electronic and online surveys across three time points - pre-shooting (T1), 1-month post-shooting (T2), and 6-months post-shooting (T3). As expected, few participants (14.4%) sought any treatment. Of note, 77.5% of participants endorsed at least one risk factor for PTSD. Prevalence rates of probable PTSD significantly decreased from 51.8% of the full sample at T2 to 12.9% at T3. Results showed that a significantly higher proportion of participants with probable PTSD at T3 sought treatment than those participants at minimal to no risk for PTSD. Psychotherapy was sought at higher rates than medication or combined treatment across risk groups. No reliable predictors of treatment use were observed for at-risk participants or those with probable PTSD. Research and clinical suggestions for optimizing post-disaster recovery and improving treatment utilization among students following campus shootings are discussed.
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Affiliation(s)
- Derrecka M Boykin
- Department of Psychology, Northern Illinois University, DeKalb, Illinois, USA
| | - Holly K Orcutt
- Department of Psychology, Northern Illinois University, DeKalb, Illinois, USA
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Jiang T, Webster JL, Robinson A, Kassam-Adams N, Richmond TS. Emotional responses to unintentional and intentional traumatic injuries among urban black men: A qualitative study. Injury 2018; 49:983-989. [PMID: 29248186 PMCID: PMC5932248 DOI: 10.1016/j.injury.2017.12.002] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2017] [Revised: 11/08/2017] [Accepted: 12/05/2017] [Indexed: 02/02/2023]
Abstract
PURPOSE The burden of injuries is disproportionately concentrated among Black men in the United States. Previous studies suggest that the mental health effects of trauma may vary by the intentionality of the injury (intentional vs. unintentional), yet little is known about this experience among Black men. We explored the emotional responses to traumatic injuries in the context of injury intentionality among Black men in an urban area. METHODS We conducted semi-structured, qualitative interviews with 74 Black men who were traumatically injured. The interviews took place three months after discharge from the hospital and they were audiotaped, transcribed, and de-identified. We used systematic thematic analysis to identify themes about post-trauma emotional responses to intentional and unintentional injuries. RESULTS The narratives of intentionally injured men revealed persistent exposure to neighborhood violence and their distrust of others including the people they knew and to whom they felt close. Survivors of unintentional injuries did not express a similar distrust of others. Our findings suggest that survivors of intentional injuries experience loss of social support following their injuries. CONCLUSIONS Emotional responses can differ by intentionality of traumatic injury among urban Black men. Intentional injuries may be a marker for chronic exposure to violence and limited social support for recovery. Additional resources should be targeted to survivors of intentional injury who return to disadvantaged communities after medical treatment to decrease risk of re-traumatization and adverse emotional responses.
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Affiliation(s)
- Tammy Jiang
- Department of Epidemiology, Boston University School of Public Health, Boston, Massachusetts, USA
| | - Jessica L. Webster
- University of Pennsylvania School of Nursing, Philadelphia, Pennsylvania, USA
| | - Andrew Robinson
- University of Pennsylvania School of Nursing, Philadelphia, Pennsylvania, USA
| | - Nancy Kassam-Adams
- The Center for Injury Research and Prevention, The Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - Therese S. Richmond
- Division of Biobehavioral and Health Sciences, University of Pennsylvania School of Nursing, Philadelphia, Pennsylvania, USA
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Post-traumatic Stress Disorder and Social Isolation among North Korean Refugee Women in South Korea: The Moderating Role of Formal and Informal Support. SUSTAINABILITY 2018. [DOI: 10.3390/su10041246] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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31
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Zhou B, Boyer R, Guay S. Dangers on the road: A longitudinal examination of passenger-initiated violence against bus drivers. Stress Health 2018; 34:253-265. [PMID: 28913926 DOI: 10.1002/smi.2779] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2016] [Revised: 05/18/2017] [Accepted: 07/07/2017] [Indexed: 11/11/2022]
Abstract
This study examined the impact of workplace violence against 109 bus drivers over a 1-year span. Workplace violence is related to both psychological and work-related consequences. Our findings showed that bus drivers experienced a wide range of violence at work and the psychological consequences were devastating: Half of the participants met the diagnostic criteria for acute stress disorder within the first month following the index event. Majority of them experienced at least moderate levels of post-traumatic stress disorder (PTSD) problems over the 1-year span. About 9.3% of participants showed a delayed onset of PTSD 6 months after. Furthermore, counter-supportive behaviours and reexposure to violence played important roles in the maintenance of PTSD symptoms over time. Even though PTSD symptoms per se did not relate to bus driver's confidence in coping with aggressive passengers, the immediate post-traumatic reaction-symptoms of acute stress disorder-showed a significant long-term negative effect on bus drivers' confidence in dealing with aggressive passengers 12 months after. This study provided empirical evidence of the changing nature of PTSD symptoms over time among bus drivers.
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Affiliation(s)
- Biru Zhou
- Centre for Research on Children and Families, McGill University and Trauma Studies Centre, Institut universitaire en santé mentale de Montréal, Montreal, Quebec, Canada
| | - Richard Boyer
- Department of Psychiatry, Université de Montréal and Institut universitaire en santé mentale de Montréal, Montreal, Quebec, Canada
| | - Stéphane Guay
- School of Criminology, Université de Montréal and Trauma Studies Centre, Institut universitaire en santé mentale de Montréal, Montreal, Quebec, Canada
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Ketcheson F, King L, Richardson JD. Association between social support and mental health conditions in treatment-seeking Veterans and Canadian Armed Forces personnel. JOURNAL OF MILITARY, VETERAN AND FAMILY HEALTH 2018. [DOI: 10.3138/jmvfh.2017-0001] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Affiliation(s)
| | - Lisa King
- Parkwood Operational Stress Injury Clinic, London, Ontario, Canada
| | - J Don Richardson
- Parkwood Operational Stress Injury Clinic, London, Ontario, Canada
- Department of Psychiatry, Western University, London, Ontario, Canada
- Department of Psychiatry and Behavioural Neuroscience, McMaster University, Hamilton, Ontario, Canada
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Thompson-Hollands J, Litwack SD, Ryabchenko KA, Niles BL, Beck JG, Unger W, Sloan DM. Alliance across group treatment for veterans with posttraumatic stress disorder: The role of interpersonal trauma and treatment type. ACTA ACUST UNITED AC 2018; 22:1-15. [PMID: 29755256 DOI: 10.1037/gdn0000077] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Objective Examine initial levels and pattern of change of alliance in group treatment for posttraumatic stress disorder (PTSD) for veterans. Method One hundred and seventy-eight male veterans with PTSD were recruited for this study. Participants were randomly assigned to either group cognitive behavioral therapy (GCBT) or to group present-centered therapy (GPCT). Alliance with fellow group members was assessed every other session throughout the group (total of seven assessments). Hierarchical linear modeling was used to determine whether treatment condition or index trauma type (interpersonal or non-interpersonal) impacted initial levels of alliance or change in alliance over time. Results Alliance increased significantly throughout treatment in both conditions. The presence of an interpersonal index event, compared to a non-interpersonal index event, did not significantly impact either initial levels of alliance or change in alliance over time. Participants in the GCBT condition experienced significantly greater growth in alliance over time compared to those in the GPCT condition (p > .05), but did not have significantly different initial alliance ratings. Conclusions The components and focus of the GCBT treatment may have facilitated more rapid bonding among members. Interpersonal traumatic experience did not negatively impact group alliance.
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Affiliation(s)
- Johanna Thompson-Hollands
- National Center for PTSD, Behavioral Science Division.,VA Boston Healthcare System.,Boston University School of Medicine
| | - Scott D Litwack
- VA Boston Healthcare System.,Boston University School of Medicine
| | - Karen A Ryabchenko
- National Center for PTSD, Behavioral Science Division.,VA Boston Healthcare System.,Boston University School of Medicine
| | - Barbara L Niles
- National Center for PTSD, Behavioral Science Division.,VA Boston Healthcare System.,Boston University School of Medicine
| | | | | | - Denise M Sloan
- National Center for PTSD, Behavioral Science Division.,VA Boston Healthcare System.,Boston University School of Medicine
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van der Velden PG, Pijnappel B, van der Meulen E. Potentially traumatic events have negative and positive effects on loneliness, depending on PTSD-symptom levels: evidence from a population-based prospective comparative study. Soc Psychiatry Psychiatr Epidemiol 2018; 53:195-206. [PMID: 29288318 PMCID: PMC5816097 DOI: 10.1007/s00127-017-1476-8] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2017] [Accepted: 12/17/2017] [Indexed: 11/27/2022]
Abstract
PURPOSE Examine to what extent adults affected by recent potentially traumatic events (PTE) with different PTSD-symptom levels are more at risk for post-event loneliness than non-affected adults are in the same study period. METHODS We extracted data from the Dutch longitudinal LISS panel to measure pre-event loneliness (2011) and post-event loneliness (2013 and 2014), pre-event mental health problems (2011), PTE and PTSD symptoms (2012). This panel is based on a traditional random sample drawn from the population register by Statistics Netherlands. RESULTS Results of the multinomial logistic regression analyses showed that affected adults with high levels of PTSD symptoms were more at risk for high levels of post-event loneliness than affected adults with very low PTSD-symptom levels and non-affected adults, while controlling for pre-event loneliness, pre-event mental health problems and demographics. However, affected adults with very low levels of PTSD symptoms compared to non-affected adults were less at risk for medium and high levels of post-event loneliness while controlling for the same variables. Yet, pre-event loneliness appeared to be the strongest independent predictor of loneliness at later stages: more than 80% with high pre-event levels had high post-event levels at both follow-ups. CONCLUSIONS Remarkably, potentially traumatic events have depending on PTSD-symptom levels both negative and positive effects on post-event loneliness in favor of affected adults with very low PTSD symptoms levels. However, post-event levels at later stages are predominantly determined by pre-event loneliness levels.
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Affiliation(s)
| | | | - Erik van der Meulen
- INTERVICT, Tilburg University, PO Box 90153, 5000 LE, Tilburg, The Netherlands
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35
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Sirati-Nir M, Khaghanizade M, Rahimi A, Khazaei M, Ghadirian F. The Effect of Social Support Skill-training Group Intervention on Perceived Social Support in Veterans with Posttraumatic Stress Disorder. IRANIAN JOURNAL OF NURSING AND MIDWIFERY RESEARCH 2018; 23:272-276. [PMID: 30034486 PMCID: PMC6034520 DOI: 10.4103/ijnmr.ijnmr_165_16] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Background: Traumatic events related to war have long effects on psychiatric psychopathologies. From these disturbing conditions, posttraumatic stress disorder (PTSD) is considered to be the most characteristic feature of psychiatric traumatic experience. The current study was designed to assess the effect of two social support skill-training group interventions on perceived social support in veterans with PTSD. Materials and Methods: The study was conducted with the clinical trial method. According to the inclusion criteria, 60 of 367 veterans with PTSD were selected and randomly allocated into two intervention groups and a control group. The two training programs on social support skills consisting of three sessions, each being 1.5–2 h, were held weekly for 3 weeks. The Multidimensional Scale of Perceived Social Support was filled by samples before and 6 weeks after intervention. The data were analyzed by descriptive and analytical statistics using PASW Statistics 18. Results: The ANOVA results showed that after intervention, there were significant differences in perceived social support between intervention groups and control group (F = 1.06, p = 0.001), but there was no significant difference between intervention groups by t-test (t = 28.05, p < 0.10). The paired t-test showed a significant difference in all subscale scores of perceived social support between two intervention groups before and after intervention (p < 0.05). Conclusions: The results of the current study agreed with the positive effects of social support skill training on perceived social support in veterans with PTSD. It is suggested that these training courses should be included in the community re-entry programs of veterans with PTSD.
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Affiliation(s)
- Masoud Sirati-Nir
- Department of Psychiatry, Nursing School, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Morteza Khaghanizade
- Department of Psychiatry, Nursing School, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Abolfazl Rahimi
- Department of Medical-Surgical, Nursing School, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Mohammad Khazaei
- Department of Psychiatry, Nursing School, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Fataneh Ghadirian
- Department of Psychiatric Nursing, Nursing and Midwifery School, Tehran University of Medical Sciences, Tehran, Iran
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Li M, Xu H, Wang W. An Improved Model of Physical and Emotional Social Defeat: Different Effects on Social Behavior and Body Weight of Adolescent Mice by Interaction With Social Support. Front Psychiatry 2018; 9:688. [PMID: 30618868 PMCID: PMC6297843 DOI: 10.3389/fpsyt.2018.00688] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2018] [Accepted: 11/27/2018] [Indexed: 01/29/2023] Open
Abstract
Social stress is a prevalent etiological environmental factor that can affect health, especially during adolescence. Either experiencing or witnessing a traumatic event during adolescence can increase the risk of psychiatric disorders, such as PTSD. The present study attempted to establish an improved social stress model to better distinguish the effects of physical and emotional social stress on the behavior and physiology of adolescent mice. In addition, we investigated how social support affected these stress-induced changes in social behavior. On PND 28, male littermates were exposed to either physical stress (PS) or emotional stress (ES), afterwards, half of them were paired-housed and the others were singly housed. The PS exposed mice were directly confronted with a violent aggressor using the social defeat stress (SDS) paradigm for 15 min/trial (with the total of 10 trials randomly administered over a week), while the ES exposed mice were placed in a neighboring compartment to witness the PS procedure. Our results indicate that both stressors induced an effective stress response in adolescent mice, but PS and ES had differential influence in the context of relevant social anxiety/fear and social interaction with peers. Additionally, social support following stress exposure exerted beneficial effects on the social anxiety/fear in ES exposed mice, but not on PS exposed mice, suggesting that the type of stressor may affect the intervention efficacy of social support. These findings provide extensive evidence that physical and emotional stressors induce different effects. Moreover, ES exposed mice, rather than PS exposed mice, seemed to benefit from social support. In summary, the study suggests that this paradigm will be helpful in investigating the effects of psychological intervention for the treatment of stress-related psychiatric disorders.
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Affiliation(s)
- Man Li
- Department of Psychology, Tianjin Normal University, Tianjin, China.,Academy of Psychology and Behavior, Tianjin Normal University, Tianjin, China.,Center of Collaborative Innovation for Assessment and Promotion of Mental Health, Tianjin, China.,CAS Key Laboratory of Mental Health, Institute of Psychology, Beijing, China
| | - Hang Xu
- CAS Key Laboratory of Mental Health, Institute of Psychology, Beijing, China.,Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Weiwen Wang
- CAS Key Laboratory of Mental Health, Institute of Psychology, Beijing, China.,Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
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37
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Rini C, Symes Y, Campo RA, Wu LM, Austin J. I Keep my Problems to Myself: Negative Social Network Orientation, Social Resources, and Health-Related Quality of Life in Cancer Survivors. Ann Behav Med 2017; 50:385-96. [PMID: 26693932 DOI: 10.1007/s12160-015-9765-5] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND Cancer survivors treated with hematopoietic stem cell transplant rely on their social network for successful recovery. However, some survivors have negative attitudes about using social resources (negative social network orientation) that are critical for their recovery. PURPOSE We examined the association between survivors' social network orientation and health-related quality of life (HRQoL) and whether it was mediated by social resources (network size, perceived support, and negative and positive support-related social exchanges). METHODS In a longitudinal study, 255 survivors completed validated measures of social network orientation, HRQoL, and social resources. Hypotheses were tested using path analysis. RESULTS More negative social network orientation predicted worse HRQoL (p < .001). This association was partially mediated by lower perceived support and more negative social exchanges. CONCLUSIONS Survivors with negative social network orientation may have poorer HRQoL in part due to deficits in several key social resources. Findings highlight a subgroup at risk for poor transplant outcomes and can guide intervention development.
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Affiliation(s)
- Christine Rini
- Gillings School of Global Public Health, Department of Health Behavior, University of North Carolina at Chapel Hill, Campus box 7440, 319C Rosenau Hall, Chapel Hill, NC, 27599-7440, USA.
- UNC Lineberger Comprehensive Cancer Center, Chapel Hill, NC, USA.
| | - Yael Symes
- Gillings School of Global Public Health, Department of Health Behavior, University of North Carolina at Chapel Hill, Campus box 7440, 319C Rosenau Hall, Chapel Hill, NC, 27599-7440, USA
- UNC Lineberger Comprehensive Cancer Center, Chapel Hill, NC, USA
| | - Rebecca A Campo
- Department of Physical Medicine and Rehabilitation, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Lisa M Wu
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
- Robert H. Lurie Comprehensive Cancer Center, Chicago, IL, USA
| | - Jane Austin
- Department of Psychology, William Paterson University, Wayne, NJ, USA
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Three Types of Intimate Relationships among Individuals with Chronic Pain and a History of Trauma Exposure. Healthcare (Basel) 2017; 5:healthcare5040068. [PMID: 28961164 PMCID: PMC5746702 DOI: 10.3390/healthcare5040068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2017] [Revised: 09/06/2017] [Accepted: 09/22/2017] [Indexed: 11/17/2022] Open
Abstract
Individuals with chronic pain often have psychiatric disorders, such as depression and posttraumatic stress disorder (PTSD), which can affect their intimate relationship satisfaction and stability. Little is known about the nature of support stemming from chronic pain patients' intimate relationships, and therefore, this study sought to: (1) use cluster modeling to construct specific intimate relationship groups based on types of support patients receive, and (2) determine if there is a relationship between support type and PTSD, chronic pain, anxiety, and depression. Ward's method of cluster analysis in Stata was used to create groups based on the level of informational, affirmation, confident, emotional, and fun support received from chronic pain patients' most intimate relationship. Three types of support were identified: high (type 1, n = 17), high emotional/low instrumental (type 2, n = 9), and unstable (type 3, n = 15). Types 1 and 3 included more family members (Type 1: 100%, Type 2: 93%), than type 2 (77%). Type 2 patients experienced more trauma (Mean = 9.4 ± 1.7 vs. 7.5 ± 0.88 for types 1 and 3) and were significantly more likely to have PTSD (X² = 7.91, p < 0.05. Patients with low familial support may also benefit from PTSD screening and referral but further study is needed.
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39
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Zeligman M, Bialo JA, Brack JL, Kearney MA. Loneliness as Moderator Between Trauma and Posttraumatic Growth. JOURNAL OF COUNSELING AND DEVELOPMENT 2017. [DOI: 10.1002/jcad.12158] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Affiliation(s)
- Melissa Zeligman
- Department of Counseling and Psychological Services; Georgia State University
| | - Jacquelyn A. Bialo
- Department of Counseling and Psychological Services; Georgia State University
| | - Jane L. Brack
- Department of Counseling and Psychological Services; Georgia State University
| | - Moriah A. Kearney
- Department of Counseling and Psychological Services; Georgia State University
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40
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Dodson TS, Beck JG. Posttraumatic stress disorder symptoms and attitudes about social support: Does shame matter? J Anxiety Disord 2017; 47:106-113. [PMID: 28117191 DOI: 10.1016/j.janxdis.2017.01.005] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2016] [Revised: 12/15/2016] [Accepted: 01/12/2017] [Indexed: 10/20/2022]
Abstract
Considerable research has examined the association between posttraumatic stress disorder (PTSD) symptoms and social support. One facet of this relationship that deserves greater attention concerns trauma survivors' negative expectations towards social support, termed negative network orientation. To expand our understanding of negative network orientation, the current study examined shame as a possible mediator in the relationship between PTSD symptoms and negative network orientation, in a sample of 202 female survivors of intimate partner violence (IPV). Additionally, a history of child abuse (CA) was evaluated as a moderator of the association between shame and negative network orientation in this model. Path analyses indicated a significant indirect effect between PTSD symptoms and negative network orientation through shame, indicative of mediation. A history of CA moderated this effect, such that women with a history of CA in addition to IPV showed a significantly stronger relationship between PTSD symptoms and negative network orientation through shame, relative to women who only had a history of IPV. These findings support the relevance of shame in understanding the association between PTSD symptoms and negative beliefs about social support and highlight the role of childhood abuse as a moderator in this process among IPV survivors.
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Affiliation(s)
| | - J Gayle Beck
- Department of Psychology, University of Memphis, USA
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41
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Creating a Safe Haven Following Child Maltreatment : The Benefits and Limits of Social Support. PARENTING AND FAMILY PROCESSES IN CHILD MALTREATMENT AND INTERVENTION 2017. [DOI: 10.1007/978-3-319-40920-7_2] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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42
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Lee H, Noh J. Pair exposure with conspecific during fear conditioning induces the link between freezing and passive avoidance behaviors in rats. Neurosci Res 2016; 108:40-5. [PMID: 26827818 DOI: 10.1016/j.neures.2016.01.005] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2015] [Revised: 01/19/2016] [Accepted: 01/19/2016] [Indexed: 01/31/2023]
Abstract
Social factor plays an important role in dealing with posttraumatic stress disorder related to excessive physiological fear response and insufficient fear memory extinction of the brain. However, although social circumstances occurred not only during contextual retrieval but also during fear conditioning, most previous studies focused on the advantageous aspects of social buffering in fear retrieval period. To demonstrate the association between fear responses and fear memory from social stimuli during fear conditioning, pair exposed rats with conspecific as social buffering were subjected to a fear conditioning of passive avoidance test to evaluate memory function and freezing behavior. Whereas single exposed rats showed the significant increase of freezing behaviors and passive avoidance behaviors compared to control rats, pair exposed rats showed significant alleviation of the freezing behaviors and passive avoidance behaviors compared to single exposed rats. Furthermore, we determined a significant correlation between freezing and passive avoidance behavioral alteration in pair exposed rats. Taken together, we suggest that pair exposure with conspecific during fear conditioning helps to cope with both freezing response and fear memory systems and their reciprocal interaction has a crucial potential as a resource for the relief of unreasonable stress responses in posttraumatic stress disorder.
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Affiliation(s)
- Hyunchan Lee
- Department of Science Education, College of Education, Dankook University, 152 Jukjeon-ro, Suji-gu, Yongin-si, Gyeonggi-do 16890, Republic of Korea
| | - Jihyun Noh
- Department of Science Education, College of Education, Dankook University, 152 Jukjeon-ro, Suji-gu, Yongin-si, Gyeonggi-do 16890, Republic of Korea.
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43
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Schirk DK, Lehman EB, Perry AN, Ornstein RM, McCall-Hosenfeld JS. The impact of social support on the risk of eating disorders in women exposed to intimate partner violence. Int J Womens Health 2015; 7:919-31. [PMID: 26648759 PMCID: PMC4664489 DOI: 10.2147/ijwh.s85359] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Eating disorders (EDs) are often found among women exposed to intimate partner violence (IPV). The role of social support (SS) as a protective factor against ED among IPV-exposed women is not firmly established. OBJECTIVE The objective of this study is to determine the distribution of risk of EDs among women exposed to IPV and to examine the impact of SS on risk of ED among IPV-exposed women. METHODS Women (aged 18-64 years) exposed to IPV during their lifetimes (defined by the Humiliation-Afraid-Rape-Kick instrument) were recruited from primary care and domestic violence service agencies and surveyed on demographics, mood/anxiety disorders, psychosocial/community factors, and strategies used in response to IPV. The Eating Disorder Screen for Primary Care assessed the risk of ED. A modified Medical Outcomes Study Social Support Survey assessed overall functional support (scale range: 0-32; categorized into quartiles). Ordinal logistic regression examined the risk of ED based on SS, controlling for prespecified demographics (age, race/ethnicity, marital status, near-poverty level), and health-related factors significant in bivariate analyses (risky alcohol use). RESULTS Among 302 women with lifetime IPV, 41 (14%) were at high risk, 127 (42%) were at moderate risk, and 134 (44%) were at low risk of an ED. In bivariate analyses, high risk of an ED was significantly more frequent among women with a low SS score (<19, 24%) versus a high SS score (≥30, 12%) (P=0.03). High risk of an ED was significantly associated with risky alcohol use (18%) versus non-risky alcohol use (13%; P=0.008). In multivariable analysis, a 5-unit increase in overall SS was significantly associated with decreased odds of ED risk (P=0.007). CONCLUSION Among IPV-exposed women, low SS is associated with an increased risk of ED. SS may protect against ED by reducing anxiety and promoting positive actions, but further study is needed to confirm this.
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Affiliation(s)
- Dana K Schirk
- The Pennsylvania State University College of Medicine, Hershey, PA, USA
| | - Erik B Lehman
- Department of Public Health Sciences, The Pennsylvania State University College of Medicine, Hershey, PA, USA
| | - Amanda N Perry
- Department of Agricultural Economics, Sociology, and Education, Division of Rural Sociology, College of Agriculture, Pennsylvania State University, University Park, Hershey, PA, USA
| | - Rollyn M Ornstein
- Department of Pediatrics, The Pennsylvania State University College of Medicine, Hershey, PA, USA
| | - Jennifer S McCall-Hosenfeld
- Department of Public Health Sciences, The Pennsylvania State University College of Medicine, Hershey, PA, USA ; Department of Medicine, The Pennsylvania State University College of Medicine, Hershey, PA, USA
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Kenardy J, Heron-Delaney M, Warren J, Brown E. The effect of mental health on long-term health-related quality of life following a road traffic crash: results from the UQ SuPPORT study. Injury 2015; 46:883-90. [PMID: 25541415 DOI: 10.1016/j.injury.2014.11.006] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2014] [Revised: 10/23/2014] [Accepted: 11/07/2014] [Indexed: 02/02/2023]
Abstract
BACKGROUND Most research on the consequences of road traffic crashes (RTCs) has focused on serious injury cohorts, yet RTC survivors with minor injury are also affected. This study investigates the relationship between mental health and health-related quality of life (QoL) following an RTC for those with predominately minor injuries. METHODS A longitudinal cohort design with an opt-in consenting procedure was used. A letter of invitation was sent to 3146 claimants within the Compulsory Third Party (CTP) motor vehicle insurance scheme in Queensland, Australia, with a total of 382 (12%) responding to the invitation and consenting to participate in the study. Retention was high (65%) at 24 months. Survey and telephone interview data were collected at approximately 6, 12 and 24 months post-RTC. Health-related QoL (SF-36 v2) data from at least one wave was known for 343 participants. The sample was predominantly female (62%), with an average age of 48.6 years. RESULTS Participants consistently reported physical and mental health-related QoL below Australian norms. A multilevel regression analysis found overall physical health-related QoL improved with higher expectations of returning to work, but was lower with age, increasing pain, expectations of persistent pain, heightened perceived threat to life, and the presence of Posttraumatic Stress Disorder (PTSD) or Major Depressive Episode (MDE). Overall, mental health-related QoL did not improve with time, was higher with increased social support and expectations of returning to work, but was lower with increasing pain and the presence of PTSD, MDE or Generalised Anxiety Disorder (GAD). Contrary to expectations, lower injury severity was related to poorer mental health-related QoL. CONCLUSIONS Individuals with predominately minor RTC-related injuries have poor physical and mental health-related QoL, particularly when pain levels are high and comorbid psychiatric disorders are present. Of particular concern is that the low levels of reported health-related QoL do not appear to improve by 2 years post-RTC. The potential risk factors found in this study may be useful indicators for early identification and enhanced rehabilitation of those at risk of poor recovery.
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Affiliation(s)
- Justin Kenardy
- Centre of National Research on Disability and Rehabilitation Medicine (CONROD), School of Medicine, The University of Queensland, Brisbane, Queensland, Australia.
| | - Michelle Heron-Delaney
- Centre of National Research on Disability and Rehabilitation Medicine (CONROD), School of Medicine, The University of Queensland, Brisbane, Queensland, Australia; School of Psychology, Australian Catholic University, Brisbane, Queensland, Australia
| | - Jacelle Warren
- Centre of National Research on Disability and Rehabilitation Medicine (CONROD), School of Medicine, The University of Queensland, Brisbane, Queensland, Australia
| | - Erin Brown
- Centre of National Research on Disability and Rehabilitation Medicine (CONROD), School of Medicine, The University of Queensland, Brisbane, Queensland, Australia
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Kenardy J, Heron-Delaney M, Warren J, Brown EA. Effect of Mental Health on Long-Term Disability After a Road Traffic Crash: Results From the UQ SuPPORT Study. Arch Phys Med Rehabil 2015; 96:410-7. [DOI: 10.1016/j.apmr.2014.10.007] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2014] [Revised: 09/29/2014] [Accepted: 10/15/2014] [Indexed: 11/26/2022]
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Jackson Foster LJ, Beadnell B, Pecora PJ. Intergenerational pathways leading to foster care placement of foster care alumni's children. CHILD & FAMILY SOCIAL WORK 2015; 20:72-82. [PMID: 25729315 PMCID: PMC4340584 DOI: 10.1111/cfs.12057] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
This study examined a path model that postulated intergenerational relationships between biological parent psychosocial functioning and foster care alumni mental health, economic status, and social support; and from these to the likelihood of children of foster care alumni being placed in foster care. The sample included 742 adults who spent time in foster care as children with a private foster care agency and who reported having at least one biological child. A full pathway was found between poorer father's functioning to greater alumni depression, which was in turn associated with negative social support, and then a greater likelihood of child out of home placement. Other parent to alumni paths were that poorer father functioning was associated with alumni anxiety and PTSD, and poorer mother's mental health was associated with PTSD; however, anxiety and PTSD were not implicated as precursors of foster care placement of the child. Findings support the need for increased practice and policy support to address the mental health needs of parents of children in or at risk of foster care, as well as the children themselves, as family history may have a lasting influence on quality of life, even when children are raised apart from biological parents.
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Affiliation(s)
- Lovie J Jackson Foster
- Assistant Professor in the School of Social Work at the University of Pittsburgh in Pittsburgh, Pennsylvania
| | - Blair Beadnell
- Research Scientist in the School of Social Work at the University of Washington in Seattle, Washington
| | - Peter J Pecora
- Managing Director of Research Services at Casey Family Programs and Professor in the School of Social Work at the University of Washington in Seattle, Washington
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Abstract
Witnessing a traumatic event but not directly experiencing it can be psychologically quite damaging. In North America alone, ∼30% of individuals who witness a traumatic event develop post-traumatic stress disorder (PTSD). While effects of direct trauma are evident, consequences of indirect or secondary trauma are often ignored. Also unclear is the role of social support in the consequences of these experiences. The social defeat paradigm, which involves aggressive encounters by a large Long-Evans male rat (resident) towards a smaller Sprague-Dawley male rat (intruder), is considered a rodent model of PTSD. We have modified this model to create a trauma witness model (TWM) and have used our TWM model to also evaluate social support effects. Basically, when an intruder rat is placed into the home cage of a resident rat, it encounters an agonistic behavior resulting in intruder subordination. The socially defeated intruder is designated the SD rat. A second rat, the cage mate of the SD, is positioned to witness the event and is the trauma witnessing (TW) rat. Experiments were performed in two different experimental conditions. In one, the SD and TW rats were cagemates and acclimatized together. Then, one SD rat was subjected to three sessions of social defeat for 7 d. TW rat witnessed these events. After each social defeat exposure, the TW and SD rats were housed together. In the second, the TW and SD rats were housed separately starting after the first defeat. At the end of each protocol, depression-anxiety-like behavior and memory tests were conducted on the SD and TW rats, blood withdrawn and specific organs collected. Witnessing traumatic events led to depression- and anxiety-like behavior and produced memory deficits in TW rats associated with elevated corticosterone levels.
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Undavalli C, Das P, Dutt T, Bhoi S, Kashyap R. PTSD in post-road traffic accident patients requiring hospitalization in Indian subcontinent: A review on magnitude of the problem and management guidelines. J Emerg Trauma Shock 2014; 7:327-31. [PMID: 25400398 PMCID: PMC4231273 DOI: 10.4103/0974-2700.142775] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2013] [Accepted: 02/20/2014] [Indexed: 11/10/2022] Open
Abstract
Traumatic events after a road traffic accident (RTA) can be physical and/or psychological. Posttraumatic stress disorder (PTSD) is one of the major psychological conditions which affect accident victims. Psychological issues may not be addressed in the emergency department(ED) immediately. There have been reports about a mismatch between the timely referrals from ED to occupational or primary care services for these issues. If left untreated, there may be adverse effects on quality of life (QOL) and work productivity. Hospital expenses, loss of income, and loss of work could create a never ending cycle for financial difficulties and burden in trauma victims. The aim of our review is to address the magnitude of PTSD in post-RTA hospitalized patients in Indian subcontinent population. We also attempted to emphasis on few management guidelines. A comprehensive search was conducted on major databases with Medical Subject Headings (MeSH) term ‘PTSD or post-traumatic stress’ and Emergency department and vehicle or road or highway or automobile or car or truck or trauma and India. Out of 120 studies, a total of six studies met our inclusion criteria and were included in the review. Our interpretation of the problem is that; hospital expenditure due to trauma, time away from work during hospitalization, and reduction in work performance, are three major hits that can lead RTA victims to financial crisis. Proposed management guidelines are; establish a coordinated triage, implementing a screening tool in the ED, and provide psychological counseling.
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Affiliation(s)
- Chaitanya Undavalli
- Department of Preventive Medicine, Mayo Clinic College of Medicine, Rochester, MN, USA
| | - Piyush Das
- Department of Psychiatry, Mayo Clinic College of Medicine, Rochester, MN, USA
| | - Taru Dutt
- Mayo Clinic College of Medicine, Rochester, MN, USA
| | - Sanjeev Bhoi
- Department of Emergency Medicine, AIIMS, New Delhi, India
| | - Rahul Kashyap
- Department of Emergency Medicine, AIIMS, New Delhi, India ; Department of Anesthesiology and Critical Care Medicine, Mayo Clinic College of Medicine, Rochester, MN, USA
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Jiang RF, Tong HQ, Delucchi KL, Neylan TC, Shi Q, Meffert SM. Interpersonal psychotherapy versus treatment as usual for PTSD and depression among Sichuan earthquake survivors: a randomized clinical trial. Confl Health 2014; 8:14. [PMID: 25254070 PMCID: PMC4172897 DOI: 10.1186/1752-1505-8-14] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2013] [Accepted: 07/17/2014] [Indexed: 01/10/2023] Open
Abstract
Background Without effective treatment, PTSD and depression can cause persistent disability in disaster-affected populations. Methods Our objective was to test the efficacy of Interpersonal Psychotherapy (IPT) delivered by trained local personnel compared with treatment as usual (TAU) for Posttraumatic Stress Disorder (PTSD) and Major Depressive Disorder (MDD) among adults affected by the Sichuan 2008 earthquake. A small randomized controlled trial of IPT + TAU versus TAU alone was delivered by local mental health personnel in Shifang, China. Between July 2011 and January 2012, 49 adults ≥ 18 years with PTSD, MDD or both were enrolled and randomized to 12 weekly sessions of IPT + TAU (27) or TAU (22) alone x 12 weeks. IPT was then offered to the TAU group. Unblinded follow up assessments were conducted at three and six months. IPT was a 12 session, weekly one hour treatment delivered by local personnel who were trained and supervised in IPT. TAU was continuation of prescribed psychotropic medication (if applicable) and crisis counseling, as needed. Main Outcome(s) and Measures (s): Clinician Administered PTSD Scale (CAPS) PTSD diagnosis; Structured Clinical Interview for DSM-IV (SCID) for MDD diagnosis. Secondary measures included PTSD/depression symptoms, interpersonal conflict/anger, social support, self-efficacy and functioning. Results Using an intent-to-treat analysis, 22 IPT + TAU and 19 TAU participants were compared at three months post-baseline. A significantly greater reduction of PTSD and MDD diagnoses was found in the IPT group (51.9%, 30.1%, respectively) versus the TAU group (3.4%, 3.4%, respectively). Despite the small sample, the estimates for time-by-condition analyses of target outcomes (2.37 for PTSD (p = .018) and 1.91 for MDD (p = .056)) indicate the improvement was better in the IPT + TAU condition versus the TAU group. Treatment gains were maintained at 6 months for the IPT group. A similar treatment response was observed in the TAU group upon receipt of IPT. Conclusions This initial study shows that IPT is a promising treatment for reducing PTSD and depression, the two major mental health disorders affecting populations surviving natural disaster, using a design that builds local mental health care capacity. Trial Registration ClinicalTrials.Gov number, NCT01624935.
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Affiliation(s)
- Rui Fang Jiang
- Wuhan Hospital for Psychotherapy, Wuhan Mental Health Center, Tongji Medical College Huazhong University of Science and Technology, Kaiming Road 44#, Wuhan 430019, China
| | - Hui Qi Tong
- Department of Psychiatry, University of California, San Francisco, California, USA
| | - Kevin L Delucchi
- Department of Psychiatry, University of California, San Francisco, California, USA
| | - Thomas C Neylan
- Department of Psychiatry, University of California, San Francisco, California, USA
| | - Qijia Shi
- Wuhan Hospital for Psychotherapy, Wuhan Mental Health Center, Tongji Medical College Huazhong University of Science and Technology, Kaiming Road 44#, Wuhan 430019, China
| | - Susan M Meffert
- Wuhan Hospital for Psychotherapy, Wuhan Mental Health Center, Tongji Medical College Huazhong University of Science and Technology, Kaiming Road 44#, Wuhan 430019, China
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Powers MB, Warren AM, Rosenfield D, Roden-Foreman K, Bennett M, Reynolds MC, Davis ML, Foreman ML, Petrey LB, Smits JAJ. Predictors of PTSD symptoms in adults admitted to a Level I trauma center: a prospective analysis. J Anxiety Disord 2014; 28:301-9. [PMID: 24632075 PMCID: PMC4004712 DOI: 10.1016/j.janxdis.2014.01.003] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2013] [Revised: 01/10/2014] [Accepted: 01/25/2014] [Indexed: 11/26/2022]
Abstract
Trauma centers are an ideal point of intervention in efforts to prevent posttraumatic stress disorder (PTSD). In order to assist in the development of prevention efforts, this study sought to identify early predictors of PTSD symptoms among adults admitted to a Level I trauma center using a novel analytic strategy (Fournier et al., 2009). Upon admission, participants (N=327) were screened for PTSD symptoms and provided information on potential predictor variables. Their PTSD symptoms were assessed again 3 months later (N=227). Participants were classified as symptomatic (positive PTSD screen) or asymptomatic (negative PTSD screen) at the follow-up assessment. Multinomial logistic regression showed that age, depression, number of premorbid psychiatric disorders, gunshot wound, auto vs. pedestrian injury, and alcohol use predicted who had PTSD symptoms at FU with 76.3% accuracy. However, when controlling for PTSD severity at baseline, only age, number of premorbid psychiatric disorders, and gunshot wounds predicted PTSD symptoms at FU but with 78.5% accuracy. These findings suggest that psychological prevention efforts in trauma centers may be best directed toward adults who are young, have premorbid psychiatric disorders, and those admitted with gunshot wounds.
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