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Ahsan A, Nadeem A, Habib A, Basaria AAA, Tariq R, Raufi N. Post-traumatic stress disorder following childbirth: a neglected cause. Front Glob Womens Health 2023; 4:1273519. [PMID: 38130709 PMCID: PMC10733854 DOI: 10.3389/fgwh.2023.1273519] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2023] [Accepted: 11/23/2023] [Indexed: 12/23/2023] Open
Abstract
Post-traumatic stress disorder (PTSD) following childbirth is a significant mental health risk for women globally. However, it remains a neglected cause, particularly in low-income countries like Pakistan. This paper explores the unique challenges faced by women in such settings, including limited access to healthcare and social support, cultural norms, and stigma surrounding mental health. The diagnosis and causes of postpartum PTSD are discussed, along with its effects on both mothers and their infants. The lack of awareness and training among healthcare professionals in recognizing and treating postpartum PTSD is highlighted as a major barrier to adequate care. To address these challenges, the paper proposes a comprehensive approach, including raising public awareness, providing mental health support and resources, and integrating postpartum mental health into medical education. Trauma-focused therapies are recommended for effective treatment. The paper concludes with the need for more research in low-income countries and emphasizes the importance of understanding and supporting women with postpartum PTSD to improve their well-being and maternal and child health.
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Affiliation(s)
- Areeba Ahsan
- Department of Medicine, Dow University of Health Sciences, Karachi, Pakistan
| | - Abdullah Nadeem
- Department of Medicine, Dow University of Health Sciences, Karachi, Pakistan
| | - Ashna Habib
- Department of Medicine, Dow University of Health Sciences, Karachi, Pakistan
| | | | - Rabeea Tariq
- Department of Medicine, Dow University of Health Sciences, Karachi, Pakistan
| | - Nahid Raufi
- Department of Medicine, Kabul Medical University, Kabul, Afghanistan
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Korem N, Ben-Zion Z, Spiller TR, Duek OA, Harpaz-Rotem I, Pietrzak RH. Correlates of avoidance coping in trauma-exposed U.S. military veterans: Results from the National Health and Resilience in Veterans Study. J Affect Disord 2023; 339:89-97. [PMID: 37437721 DOI: 10.1016/j.jad.2023.07.036] [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: 03/06/2023] [Revised: 06/13/2023] [Accepted: 07/08/2023] [Indexed: 07/14/2023]
Abstract
Avoidant coping strategies, which involve cognitions and behaviors aimed to avoid dealing with stressful experiences, are associated with adverse long-term mental and physical health outcomes. In response to traumatic events, these strategies can be maladaptive as they may interfere with the adaptive integration of traumatic events into consolidated memories. Using data from a nationally representative sample of more than 3000 trauma-exposed U.S. military veterans (mean time since trauma 30.9 years, SD = 19.9), we employed a network analytic approach to examine pairwise associations between key sociodemographic, personality, and psychosocial risk factors in relation to the endorsement of avoidant coping strategies. Results revealed that negative affect symptoms of posttraumatic stress disorder (PTSD) and adverse childhood experiences were positively associated with engagement in avoidance coping, and that greater emotional stability and conscientiousness were negatively associated with this measure. Secondary network analysis of individual negative affect symptoms of PTSD suggested that blaming oneself and/or others for the traumatic event, emotional neglect, and sexual abuse were most strongly linked to avoidance coping. Collectively, these results suggest that strong feelings of blame related to trauma, emotional neglect, and sexual abuse are associated with greater likelihood of engaging in avoidance coping, while emotional stability and conscientiousness are associated with a lower likelihood of engaging in such strategies.
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Affiliation(s)
- Nachshon Korem
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA; Department of Comparative Medicine, Yale University School of Medicine, New Haven, CT, USA; U.S. Department of Veterans Affairs National Center for Posttraumatic Stress Disorder, VA Connecticut Healthcare System, West Haven, CT, USA.
| | - Ziv Ben-Zion
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA; Department of Comparative Medicine, Yale University School of Medicine, New Haven, CT, USA; U.S. Department of Veterans Affairs National Center for Posttraumatic Stress Disorder, VA Connecticut Healthcare System, West Haven, CT, USA
| | - Tobias R Spiller
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA; U.S. Department of Veterans Affairs National Center for Posttraumatic Stress Disorder, VA Connecticut Healthcare System, West Haven, CT, USA; University of Zurich (UZH), Zurich, Switzerland; Department of Consultation-Liaison Psychiatry and Psychosomatic Medicine, University Hospital Zurich (USZ), Zurich, Switzerland; Psychiatric University Hospital Zurich (PUK), Zurich, Switzerland
| | - Or A Duek
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA; Department of Epidemiology, Biostatistics and Community Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Ilan Harpaz-Rotem
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA; U.S. Department of Veterans Affairs National Center for Posttraumatic Stress Disorder, VA Connecticut Healthcare System, West Haven, CT, USA; Department of Psychology, Yale University, New Haven, CT, USA
| | - Robert H Pietrzak
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA; U.S. Department of Veterans Affairs National Center for Posttraumatic Stress Disorder, VA Connecticut Healthcare System, West Haven, CT, USA; Department of Social and Behavioral Sciences, Yale School of Public Health, New Haven, CT, USA
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