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Rodríguez MN, Colgan DD, Leyde S, Pike K, Merrill JO, Price CJ. Trauma exposure across the lifespan among individuals engaged in treatment with medication for opioid use disorder: differences by gender, PTSD status, and chronic pain. Subst Abuse Treat Prev Policy 2024; 19:25. [PMID: 38702783 PMCID: PMC11067259 DOI: 10.1186/s13011-024-00608-8] [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: 12/13/2023] [Accepted: 04/22/2024] [Indexed: 05/06/2024] Open
Abstract
BACKGROUND There is little study of lifetime trauma exposure among individuals engaged in medication treatment for opioid use disorder (MOUD). A multisite study provided the opportunity to examine the prevalence of lifetime trauma and differences by gender, PTSD status, and chronic pain. METHODS A cross-sectional study examined baseline data from participants (N = 303) enrolled in a randomized controlled trial of a mind-body intervention as an adjunct to MOUD. All participants were stabilized on MOUD. Measures included the Trauma Life Events Questionnaire (TLEQ), the Brief Pain Inventory (BPI), and the Posttraumatic Stress Disorder Checklist (PCL-5). Analyses involved descriptive statistics, independent sample t-tests, and linear and logistic regression. RESULTS Participants were self-identified as women (n = 157), men (n = 144), and non-binary (n = 2). Fifty-seven percent (n = 172) self-reported chronic pain, and 41% (n = 124) scored above the screening cut-off for PTSD. Women reported significantly more intimate partner violence (85%) vs 73%) and adult sexual assault (57% vs 13%), while men reported more physical assault (81% vs 61%) and witnessing trauma (66% vs 48%). Men and women experienced substantial childhood physical abuse, witnessed intimate partner violence as children, and reported an equivalent exposure to accidents as adults. The number of traumatic events predicted PTSD symptom severity and PTSD diagnostic status. Participants with chronic pain, compared to those without chronic pain, had significantly more traumatic events in childhood (85% vs 75%). CONCLUSION The study found a high prevalence of lifetime trauma among people in MOUD. Results highlight the need for comprehensive assessment and mental health services to address trauma among those in MOUD treatment. TRIAL REGISTRATION NCT04082637.
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Affiliation(s)
- Monique N Rodríguez
- Department of Individual, Family, and Community Education, University of New Mexico USA, Simpson Hall MSC053042, 502 Campus, Blvd, Albuquerque, NM, 87131, USA
| | - Dana D Colgan
- Department of Neurology, Oregon Health and Science University USA, 3818 SW Sam Jackson Parkway, Portland, OR, 97229, USA
- Helfgott Research Center, National University of Natural Medicine USA, Portland, USA
| | - Sarah Leyde
- School of Medicine, University of Washington, Seattle, WA, 98104, USA
| | - Kenneth Pike
- Department of Child Family and Population Health Nursing, University of Washington USA, Seattle, USA
| | - Joseph O Merrill
- School of Medicine, University of Washington, Seattle, WA, 98104, USA
| | - Cynthia J Price
- Department of Biobehavioral Nursing and Health Informatics, University of WA, Seattle, USA.
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Rodríguez MN, Colgan DD, Leyde S, Pike K, Merrill JO, Price CJ. Trauma Exposure Across the Lifespan among Individuals Engaged in Treatment with Medication for Opioid Use Disorder: Differences by Gender, PTSD Status, and Chronic Pain. RESEARCH SQUARE 2023:rs.3.rs-3750143. [PMID: 38196650 PMCID: PMC10775379 DOI: 10.21203/rs.3.rs-3750143/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/11/2024]
Abstract
Background There is little study of lifetime trauma exposure among individuals engaged in medication treatment for opioid use disorder (MOUD). A multisite study provided the opportunity to examine the prevalence of lifetime trauma and differences by gender, PTSD status, and chronic pain. Methods A cross-sectional study examined baseline data from participants (N = 303) enrolled in a randomized controlled trial of a mind-body intervention as an adjunct to MOUD. All participants were stabilized on MOUD. Measures included the Trauma Life Events Questionnaire (TLEQ), the Brief Pain Inventory (BPI), and the Posttraumatic Stress Disorder Checklist (PCL-5). Analyses involved descriptive statistics, independent sample t-tests, and linear and logistic regression. Results Participants were self-identified as women (n = 157), men (n = 144), and non-binary (n = 2). Fifty-seven percent (n = 172) self-reported chronic pain, and 41% (n = 124) scored above the screening cut-off for PTSD. Women reported significantly more intimate partner violence (85%) vs 73%) and adult sexual assault (57% vs 13%), while men reported more physical assault (81% vs 61%) and witnessing trauma (66% vs 48%). Men and women experienced substantial childhood physical abuse, witnessed intimate partner violence as children, and reported an equivalent exposure to accidents as adults. The number of traumatic events predicted PTSD symptom severity and PTSD diagnostic status. Participants with chronic pain, compared to those without chronic pain, had significantly more traumatic events in childhood (85% vs 75%). Conclusions The study found a high prevalence of lifetime trauma among people in MOUD. Results highlight the need for comprehensive assessment and mental health services to address trauma among those in MOUD treatment. Trial Registration NCT04082637.
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Lotzin A, Morozova-Larina O, Paschenko S, Paetow A, Schratz L, Keller V, Krupelnytska L. War-related stressors and ICD-11 (complex) post-traumatic stress disorders in Ukrainian students living in Kyiv during the Russian-Ukrainian war. Psychiatry Res 2023; 330:115561. [PMID: 37956590 DOI: 10.1016/j.psychres.2023.115561] [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: 07/05/2023] [Revised: 10/24/2023] [Accepted: 10/25/2023] [Indexed: 11/15/2023]
Abstract
We estimated the prevalence of war-related stressors (Harvard Trauma Questionnaire-R), risk of ICD-11 posttraumatic stress disorder (PTSD), and complex posttraumatic stress disorder (CPTSD; International Trauma Questionnaire-R) in N = 563 Ukrainian students living in Kyiv, an active war zone between December 2022 and January 2023. Among trauma survivors (n = 381), we used multinomial logistic regression to examine whether different war-related traumatic events and cumulative trauma increased risk for ICD-11-PTSD and CPTSD after controlling for other traumatic events, age, and gender. Nine of ten Ukrainian students (91.5%) reported at least one war-related stressor, one of five (20.8%) reported four or more stressors. War-related combat situations were reported most frequently (59.5%), followed by forced separation from family members (54.5%), lack of shelter (53.3%), and murder or violent death of a family member or friend (15.6%). Rates for probable ICD-11 PTSD and CPTSD were 12.4% and 11.2%, respectively. Sexual violence and cumulative trauma exposure significantly increased the risk of CPTSD compared to other traumatic events. The high proportions of ICD-11-PTSD and CPTSD underscore the psychological burden of Ukrainian students living in an active war zone and the need for trauma-focused interventions for war-affected populations.
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Affiliation(s)
- Annett Lotzin
- Institute for Clinical Psychology and Psychotherapy, Department of Psychology, MSH Medical School Hamburg, Hamburg, Germany; Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
| | - Olha Morozova-Larina
- Taras Shevchenko National University of Kyiv, Department of Psychodiagnostics and Clinical Psychology, Kyiv, Ukraine
| | - Svitlana Paschenko
- Taras Shevchenko National University of Kyiv, Department of Developmental Psychology, Kyiv, Ukraine
| | - Antje Paetow
- Institute for Clinical Psychology and Psychotherapy, Department of Psychology, MSH Medical School Hamburg, Hamburg, Germany
| | - Lisa Schratz
- Institute for Clinical Psychology and Psychotherapy, Department of Psychology, MSH Medical School Hamburg, Hamburg, Germany
| | - Vladyslava Keller
- Taras Shevchenko National University of Kyiv, Department of Psychodiagnostics and Clinical Psychology, Kyiv, Ukraine
| | - Liudmyla Krupelnytska
- Taras Shevchenko National University of Kyiv, Department of Psychodiagnostics and Clinical Psychology, Kyiv, Ukraine
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Chen B, Zhang J, Yu S, Yu NX. Trajectories and determinants of acute stress disorder during the COVID-19 centralized quarantine: A latent class growth analysis. Stress Health 2023. [PMID: 38018760 DOI: 10.1002/smi.3351] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Revised: 05/04/2023] [Accepted: 11/16/2023] [Indexed: 11/30/2023]
Abstract
COVID-19 centralized quarantine may cause acute stress disorder (ASD). However, it is unknown how individuals present heterogeneous ASD trajectories during the COVID-19 centralized quarantine and what factors contribute to these patterns. This study aimed to identify the ASD trajectories and their determinants during the centralized quarantine period, and the mediating effects of resilience on these associations. A longitudinal survey with three waves was conducted in a randomly selected quarantine hotel in Shenzhen, China from October to November 2020. A total of 273 participants completed online measures assessing ASD symptoms, Eysenck's personality constructs of extraversion (E), neuroticism (N), psychoticism (P), and resilience on Day 1, and reported ASD symptoms on Days 7 and 14 during their 14-day centralized quarantine periods. Latent class growth analysis identified three trajectories: constantly high symptoms (CHS, 4.76%), decreasing symptoms (DS, 11.72%), and constantly low symptoms (CLS, 83.52%). The CHS and DS subgroups both reported lower E and higher N scores, but not P, compared with the CLS subgroup. Resilience mediated the effects of three personality constructs on ASD trajectories, except for the association between N and DS membership. Our study highlights the heterogeneity in stress responses to the COVID-19 centralized quarantine. The high-risk subgroup with persistent ASD symptoms was characterized by lower E and higher N. The resilience process accounted for the effects of personality in shaping distinct ASD trajectories. Our findings have implications to detect the populations vulnerable to ASD and provide insights for developing timely resilience enhancement intervention programs.
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Affiliation(s)
- Bowen Chen
- Department of Social and Behavioural Sciences, City University of Hong Kong, Hong Kong SAR, China
| | - Jun Zhang
- School of Nursing, Wuhan University, Wuhan, China
| | - Shuxin Yu
- School of Nursing, Wuhan University, Wuhan, China
- The Second People's Hospital of Futian District, Shenzhen, China
| | - Nancy Xiaonan Yu
- Department of Social and Behavioural Sciences, City University of Hong Kong, Hong Kong SAR, China
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Hennemann S, Killikelly C, Hyland P, Maercker A, Witthöft M. Somatic symptom distress and ICD-11 prolonged grief in a large intercultural sample. Eur J Psychotraumatol 2023; 14:2254584. [PMID: 37767693 PMCID: PMC10540649 DOI: 10.1080/20008066.2023.2254584] [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: 12/19/2022] [Accepted: 07/12/2023] [Indexed: 09/29/2023] Open
Abstract
Background: Grief is a multi-faceted experience including emotional, social, and physical reactions. Research in ICD-11 prolonged grief disorder (PGD) in different cultural contexts has revealed different or potentially missing grief symptoms that may be relevant.Objective: This study thus aimed to explore the prevalence of somatic symptom distress and its associations with grief and negative affect in a culturally diverse sample of bereaved individuals with symptoms of PGD.Methods: Based on cross-sectional survey data from the Measurement and Assessment of Grief (MAGIC) project, this study included 1337 participants (mean age 23.79 yrs, 76.1% female) from three regions (USA: 62.3%, Turkey/Iran: 24.2%, Cyprus/Greece: 13.5%), who experienced a loss of a significant other. Associations between somatic symptom distress (Somatic Symptom Scale, SSS-8), symptoms of PGD (International Prolonged Grief Disorder Scale, IPGDS-33), anxiety (Generalized Anxiety Disorder Questionnaire, GAD-7), depression (Patient Health Questionnaire, PHQ-9) as well as demographic and loss related characteristics were investigated. Three hundred and thirteen participants (23.4%) scored above the proposed cut-off for clinically severe PGD.Results: 'High' or 'very high' levels of somatic symptom distress were more frequent in a possible PGD group (58.2%), than in a non-PGD group (22.4%), p < .001, as divided per cut-off in the IPGDS. In a multiple regression analysis, PGD symptoms were significantly but weakly associated with somatic symptom distress (β = 0.08, p < .001) beyond demographics, loss-related variables, and negative affect. Negative affect (anxiety and depression) mediated the relationship of PGD symptoms with somatic symptom distress and the indirect effect explained 58% of the variance.Conclusions: High levels of somatic symptom distress can be observed in a substantial proportion of bereaved across cultures. Our findings suggest that PGD is related to somatic symptom distress partly and indirectly through facets of negative affect.
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Affiliation(s)
- Severin Hennemann
- Department of Clinical Psychology, Psychotherapy and Experimental Psychopathology, Johannes Gutenberg University Mainz, Mainz, Germany
| | - Clare Killikelly
- Department of Psychology, University of Zurich, Zurich, Switzerland
| | - Philip Hyland
- Department of Psychology, Maynooth University, Kildare, Ireland
| | - Andreas Maercker
- Department of Psychology, University of Zurich, Zurich, Switzerland
| | - Michael Witthöft
- Department of Clinical Psychology, Psychotherapy and Experimental Psychopathology, Johannes Gutenberg University Mainz, Mainz, Germany
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Whitt-Woosley A, Sprang G. Analysis of implementation drivers of secondary traumatic stress (STS)-informed organizational change and experiences of STS and burnout in child welfare. CHILD ABUSE & NEGLECT 2023; 141:106194. [PMID: 37178529 DOI: 10.1016/j.chiabu.2023.106194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Revised: 03/02/2023] [Accepted: 04/04/2023] [Indexed: 05/15/2023]
Abstract
BACKGROUND STS and burnout (BO) are significant problems for child welfare professionals (Bride, 2007; Craig & Sprang, 2010). A challenge for at-risk professions is to understand how both individuals and organizations can address the potential impact of these conditions. OBJECTIVE This study explores the influence of organizational factors on individual experiences of STS and BO in child welfare settings. PARTICIPANTS AND SETTING Study participants were 382 child welfare professionals in the United States who were participating in an organizational assessment of STS and related activities. METHOD The Secondary Traumatic Stress Informed Organizational Assessment (STSI-OA) tool (Sprang et al., 2014) was administered to evaluate the use of policies, practices and training activities that address STS and BO (Sprang et al., 2014). The National Implementation Research Network's (NIRN) implementation framework was applied to the STSI-OA and domain activities loaded onto the three implementation drivers of competency, organization and leadership (Sprang, Ross, & Miller, 2018). Regression analyses were conducted to determine the strength of associations between the implementation drivers of STS informed organizational activity and individual ratings of STS and BO. RESULT Increased use of STS-informed activities affiliated with all three implementation drivers was significantly associated with lower individual STS and BO scores. STS-informed activities associated with the organization driver seemed particularly effective for addressing STS. CONCLUSION This study supports the utility of the integrated framework for enacting STS-informed change in child welfare contexts. Recommendations for organizations and future research are provided.
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Affiliation(s)
- Adrienne Whitt-Woosley
- University of Kentucky, College of Medicine, Department of Psychiatry, United States of America.
| | - Ginny Sprang
- University of Kentucky, College of Medicine, Department of Psychiatry, United States of America
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Karstoft KI, Armour C. What we talk about when we talk about trauma: Content overlap and heterogeneity in the assessment of trauma exposure. J Trauma Stress 2023; 36:71-82. [PMID: 36161361 DOI: 10.1002/jts.22880] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Revised: 08/12/2022] [Accepted: 08/16/2022] [Indexed: 11/08/2022]
Abstract
The accurate definition and assessment of trauma exposure is the foundation for replicable studies of mental health problems following trauma exposure. However, scales developed to assess trauma exposure might vary widely in terms of item content; overlap; and specifications of trauma intensity, frequency, duration, and timing. We compared eight frequently used self-report measures of trauma exposure to address content overlap and measurement heterogeneity. Combined, these measures assess 44 disparate exposures. Mean overlap across scales was moderate (M = 0.41, range: 0.25-0.48 across scales). Pairwise overlap between scales ranged from .19 to .59. We found 18 exposures (40.9%) that were included in one scale and three exposures (6.8%) that were included in all eight scales. Four of the included scales assess trauma frequency, five assess intensity or perceived danger, two assess duration, and four assess timing. The implications of measurement heterogeneity for clinical research as well as for comparability and replication of trauma-related research are discussed.
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Affiliation(s)
| | - Chérie Armour
- Research Centre for Stress Trauma and Related Conditions (STARC), School of Psychology, Queen's University Belfast, Belfast, Northern Ireland, United Kingdom
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Alberque B, Laporte C, Mondillon L, Baker JS, Mermillod M, Brousse G, Ugbolube UC, Bagheri R, Bouillon-Minois JB, Dutheil F. Prevalence of Post-Traumatic Stress Disorder (PTSD) in Healthcare Workers following the First SARS-CoV Epidemic of 2003: A Systematic Review and Meta-Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:13069. [PMID: 36293650 PMCID: PMC9603193 DOI: 10.3390/ijerph192013069] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Revised: 09/30/2022] [Accepted: 10/06/2022] [Indexed: 06/16/2023]
Abstract
The world is still in the grip of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic, with putative psychological consequences for healthcare workers (HCWs). Exploring the prevalence of post-traumatic stress disorder (PTSD) during the first SARS-CoV-1 epidemic in 2003 may inform us of the long-term effects of the actual pandemic, as well as putative influencing factors such as contact with the virus, time effects, or the importance of some sociodemographic data. This information may help us develop efficient preventive strategies. Therefore, we conducted a systematic review and meta-analysis on the prevalence of PTSD in HCWs following the SARS-CoV-1 in 2003. PubMed, Embase, Google Scholar, Psychinfo, and Web of Science were searched until September 2022. Random-effects meta-analyses were stratified by the time of follow-up. We included 14 studies: 4842 HCWs (32.0 years old, 84% women). The overall prevalence of PTSD was 14% (95CI 10 to 17%). The prevalence of PTSD was 16% (8 to 24%) during the epidemic, 19% (16 to 22%) within 6 months after the epidemic, and 8% (4 to 13%) more than one year after the end of the epidemic. The longest follow-up was three years after the epidemic, with 10% of HCWs with PTSD. Nevertheless, the prevalence of PTSD was significantly lower more than one year after the end of the epidemic than the first six months after the epidemic (Coefficient -10.4, 95CI -17.6 to -3.2, p = 0.007). In conclusion, the prevalence of PTSD in HCWs was high during the first epidemic of SARS-CoV in 2003 and remained high in the long term. The lessons from the SARS-CoV-1 epidemic may help prevent a wave of PTSD following the latest COVID-19 pandemic.
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Affiliation(s)
- Bastien Alberque
- Université Clermont Auvergne, CNRS, LaPSCo, Physiological and Psychosocial Stress, CHU Clermont-Ferrand, 63000 Clermont-Ferrand, France
| | - Catherine Laporte
- Université Clermont Auvergne, Clermont Auvergne INP, CHU Clermont-Ferrand, CNRS, Institut Pascal, 63000 Clermont-Ferrand, France
| | - Laurie Mondillon
- Université Clermont Auvergne, CNRS, LaPSCo, Physiological and Psychosocial Stress, CHU Clermont-Ferrand, 63000 Clermont-Ferrand, France
| | - Julien S. Baker
- Centre for Health and Exercise Science Research, Hong Kong Baptist University, Kowloon Tong, Hong Kong 999077, China
| | | | - George Brousse
- Département de Psychiatrie, Université Clermont Auvergne, CHU Clermont-Ferrand, EA 7280 Clermont-Ferrand, France
| | - Ukadike Chris Ugbolube
- School of Health and Life Sciences, University of the West of Scotland, South Lanarkshire G72 0LH, UK
| | - Reza Bagheri
- Department of Exercise Physiology, University of Isfahan, Isfahan 81746-73441, Iran
| | - Jean-Baptiste Bouillon-Minois
- Université Clermont Auvergne, CNRS, LaPSCo, Physiological and Psychosocial Stress, CHU Clermont-Ferrand, 63000 Clermont-Ferrand, France
| | - Frédéric Dutheil
- Université Clermont Auvergne, CNRS, LaPSCo, Physiological and Psychosocial Stress, CHU Clermont-Ferrand, 63000 Clermont-Ferrand, France
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El Zouki CJ, Chahine A, Mhanna M, Obeid S, Hallit S. Rate and correlates of post-traumatic stress disorder (PTSD) following the Beirut blast and the economic crisis among Lebanese University students: a cross-sectional study. BMC Psychiatry 2022; 22:532. [PMID: 35931970 PMCID: PMC9356397 DOI: 10.1186/s12888-022-04180-y] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Accepted: 08/01/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Post-traumatic stress disorder (PTSD) is a mental illness that develops in some people after they have experienced a stunning, scary, or dangerous incident. Due to major disasters like as the Economic Crisis and the Beirut Blast, Lebanese people are struggling with a variety of mental health issues. The study objectives were to find the rate of PTSD and its association with stress, anxiety, depression, financial well-being and coping strategies among university students in Lebanon. METHODS This is a cross-sectional study, conducted between May and August 2021, which enrolled 419 university students from all districts of Lebanon. The PTSD Checklist-Specific Version (PCL-S) was used to evaluate manifestation of PSTD. RESULTS The results showed that 132 (31.5%), 109 (26.0%) and 169 (40.3%) had PTSD from COVID, Beirut blast and economic crisis respectively. More avoidant coping (Beta = 0.52) and more anxiety (Beta = 0.62) were significantly associated with more PTSD from the Beirut Blast. More avoidant coping (Beta = 0.56), depression (Beta = 0.40) and anxiety (Beta = 0.49) were significantly associated with more PTSD from the economic crisis, whereas more financial wellbeing (Beta = - 0.31) was significantly associated with less PTSD from the economic crisis. CONCLUSION Significant rates of PTSD were found in our sample of Lebanese university students, whether from the Beirut blast, or from the current economic crisis. Significant correlations of these PTSD rates were found with factors such as avoidant coping, depression, anxiety and financial wellbeing. Such findings must raise the attention to serious mental and psychosocial alteration endured by Lebanese youth that are still under fatal cumulative traumatic events, that were and even may be, intergenerationally and unintentionally transmissible, therefore, affecting not only the present, but also the future of a whole nation.
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Affiliation(s)
- Christian-Joseph El Zouki
- grid.444434.70000 0001 2106 3658School of Medicine and Medical Sciences, Holy Spirit University of Kaslik, P.O. Box 446, Jounieh, Lebanon
| | - Abdallah Chahine
- grid.444434.70000 0001 2106 3658School of Medicine and Medical Sciences, Holy Spirit University of Kaslik, P.O. Box 446, Jounieh, Lebanon
| | - Mariam Mhanna
- grid.444434.70000 0001 2106 3658School of Medicine and Medical Sciences, Holy Spirit University of Kaslik, P.O. Box 446, Jounieh, Lebanon
| | - Sahar Obeid
- School of Arts and Sciences, Social and Education Sciences Department, Lebanese American University, Jbeil, Lebanon.
| | - Souheil Hallit
- School of Medicine and Medical Sciences, Holy Spirit University of Kaslik, P.O. Box 446, Jounieh, Lebanon. .,Psychology Department, College of Humanities, Effat University, Jeddah, 21478, Saudi Arabia. .,Research Department, Psychiatric Hospital of the Cross, Jal Eddib, Lebanon.
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Nöthling J, Abrahams N, Jewkes R, Mhlongo S, Lombard C, Hemmings SMJ, Seedat S. Risk and protective factors affecting the symptom trajectory of posttraumatic stress disorder post-rape. J Affect Disord 2022; 309:151-164. [PMID: 35427719 DOI: 10.1016/j.jad.2022.04.032] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Revised: 04/05/2022] [Accepted: 04/09/2022] [Indexed: 12/30/2022]
Abstract
INTRODUCTION The prevalence of posttraumatic stress disorder (PTSD) in rape survivors is considerably higher than the prevalence in non-sexual trauma survivors. Few studies have investigated risk and protective factors in survivors early-after-rape in a prospective longitudinal design. METHODS In a sample of 639 rape-exposed women who were assessed within 20 days of rape and over 6 months, baseline data were used to predict PTSD symptom severity scores up to 6 months post-rape. RESULTS The incidence of PTSD at 3 months was 48.5% and the cumulative incidence at 6 months post-rape was 54.8%. Baseline experience of rape stigma (guilt, shame, self-blame, social devaluation and discredit) and depression were significant predictors of PTSD symptom scores over time, in mixed linear regression models. Higher levels of depression and rape stigma were associated with higher PTSD scores. Assault-related factors were not associated with PTSD scores. LIMITATIONS We could not measure PTSD symptom trajectories in all rape survivors, some of who may be at greater risk for PTSD e.g. non-disclosing rape survivors, those who declined participation and those who were extremely distressed at the time of recruitment. CONCLUSION Addressing internalised and externalised stigma and resultant mental health effects on women who present to rape clinics may reduce the long-term adverse effects of rape on mental health outcomes, such as PTSD. Rape survivors who present with high levels of depression soon after a rape should be carefully monitored and appropriately treated in order to reduce PTSD severity.
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Affiliation(s)
- Jani Nöthling
- Department of Psychiatry, Stellenbosch University, P.O. Box 241, Cape Town 8000, South Africa; Gender and Health Research Unit, South African Medical Research Council, P.O. Box 19070, Tygerberg 7505, South Africa; South African Medical Research Council Unit on the Genomics of Brain Disorders, Department of Psychiatry, Stellenbosch University, P.O. Box 241, Cape Town 8000, South Africa; Division of Epidemiology and Biostatistics, Department of Global Health, Stellenbosch University, P.O. Box 241, Cape Town 8000, South Africa.
| | - Naeemah Abrahams
- Gender and Health Research Unit, South African Medical Research Council, P.O. Box 19070, Tygerberg 7505, South Africa; Division of Social and Behavioural Sciences, School of Public Health and Family Medicine, University of Cape Town, Private Bag X3, Rondebosch 7701, South Africa
| | - Rachel Jewkes
- Gender and Health Research Unit, South African Medical Research Council, P.O. Box 19070, Tygerberg 7505, South Africa
| | - Shibe Mhlongo
- Gender and Health Research Unit, South African Medical Research Council, P.O. Box 19070, Tygerberg 7505, South Africa
| | - Carl Lombard
- Gender and Health Research Unit, South African Medical Research Council, P.O. Box 19070, Tygerberg 7505, South Africa; Biostatistics Unit, South African Medical Research Council, P.O. Box 19070, Tygerberg 7505, South Africa; Division of Epidemiology and Biostatistics, Department of Global Health, Stellenbosch University, P.O. Box 241, Cape Town 8000, South Africa
| | - Sian Megan Joanna Hemmings
- Department of Psychiatry, Stellenbosch University, P.O. Box 241, Cape Town 8000, South Africa; South African Medical Research Council Unit on the Genomics of Brain Disorders, Department of Psychiatry, Stellenbosch University, P.O. Box 241, Cape Town 8000, South Africa
| | - Soraya Seedat
- Department of Psychiatry, Stellenbosch University, P.O. Box 241, Cape Town 8000, South Africa; South African Medical Research Council Unit on the Genomics of Brain Disorders, Department of Psychiatry, Stellenbosch University, P.O. Box 241, Cape Town 8000, South Africa
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Holm T, Mors O. Psychological adjustment following mechanical restraint in individuals with schizophrenia. Nord J Psychiatry 2022; 76:104-113. [PMID: 34182878 DOI: 10.1080/08039488.2021.1939417] [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: 10/21/2022]
Abstract
AIM While it is known that being mechanically restrained during hospitalization can, in severe cases, lead to PTSD in individuals with mental illness, less is known about why some develop posttraumatic stress reactions following restraint while others do not. This study examined whether the amount of exposure to mechanical restraint and patients' interpretations of the episodes' centrality to their identity were related to symptoms of PTSD in individuals with schizophrenia. METHODS We asked 20 individuals to recall mechanical restraint episodes and rate them on centrality to identity. They also completed scales measuring symptoms of posttraumatic stress, depression, trauma history, and were rated on positive and negative symptoms. Objective information about the number of times they had been restrained was obtained through Danish health registries. RESULTS Amount of exposure to mechanical restraint was not significantly related to PTSD symptoms, potentially due to limitations of our small sample. However, interpreting episodes as more central to identity was. This relationship remained significant when controlling for trauma history, positive symptoms, and depression. CONCLUSION The results suggest that clinically significant levels of PTSD are common in this population, and that considering patients' subjective interpretations of restraint episodes, and not merely the objective facts surrounding them is important for patients' psychological adjustment.
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Affiliation(s)
- Tine Holm
- Psychosis Research Unit, Aarhus University Hospital Psychiatry, Aarhus, Denmark
| | - Ole Mors
- Psychosis Research Unit, Aarhus University Hospital Psychiatry, Aarhus, Denmark
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12
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Eising CM, Voelkle MC, Rohner SL, Maercker A, Thoma MV. Lifetime post-traumatic stress disorder in older individuals with a history of institutional upbringing in childhood: the role of social acknowledgement and stressful life events. Eur J Psychotraumatol 2021; 12:1915578. [PMID: 34104349 PMCID: PMC8168734 DOI: 10.1080/20008198.2021.1915578] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Background: Child maltreatment (CM), particularly in institutional contexts, can affect the development of post-traumatic stress disorder (PTSD). Research suggests that factors during CM (e.g. severity, variety, duration) and in the aftermath of CM (e.g. stressful life events, and social acknowledgement, i.e. the degree to which an individual feels validated and supported following a traumatic event) can explain some of the heterogeneity in PTSD development. However, there is a lack of research on long-term correlates of CM and mitigating factors, with only a few studies having been conducted with older survivors of institutional upbringing. Such research is relevant, given the long-term associations between CM and the older age status of many survivors. Objective: The current study examined the link between CM and PTSD in older individuals with a history of institutional upbringing (risk group; RG) and a matched control group (CG). Differences in stressful life events and social acknowledgement were also investigated. Method: Participants were n = 116 RG (Mage = 70.25 years, 41% female) and n = 122 CG (Mage = 70.71 years, 51% female). Data was assessed using self-report questionnaires and a clinical interview. Results: The RG reported higher levels of exposure to CM. Lifetime PTSD showed a bigger association with the level of exposure to CM, compared to having an institutional upbringing. Participants with higher CM levels reported more stressful life events. High levels of social acknowledgement mediated the relationship between CM and PTSD in the CG. Conclusions: Exposure to CM had a stronger association with PTSD than a history of institutional upbringing. In the CG, the survivors' perception of social acknowledgement ameliorated lifetime PTSD to a small extent. A critical issue for policy makers should be to enhance safeguarding measures against CM exposure, not only in institutional contexts, but also more generally, given the link to PTSD.
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Affiliation(s)
- Carla M Eising
- Psychopathology and Clinical Intervention, Institute of Psychology, University of Zürich, Zürich, Switzerland.,University Research Priority Programme "Dynamics of Healthy Ageing", University of Zürich, Zürich, Switzerland
| | - Manuel C Voelkle
- Psychological Research Methods, Humboldt University of Berlin, Berlin, Germany
| | - Shauna L Rohner
- Psychopathology and Clinical Intervention, Institute of Psychology, University of Zürich, Zürich, Switzerland.,University Research Priority Programme "Dynamics of Healthy Ageing", University of Zürich, Zürich, Switzerland
| | - Andreas Maercker
- Psychopathology and Clinical Intervention, Institute of Psychology, University of Zürich, Zürich, Switzerland.,University Research Priority Programme "Dynamics of Healthy Ageing", University of Zürich, Zürich, Switzerland
| | - Myriam V Thoma
- Psychopathology and Clinical Intervention, Institute of Psychology, University of Zürich, Zürich, Switzerland.,University Research Priority Programme "Dynamics of Healthy Ageing", University of Zürich, Zürich, Switzerland
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13
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Hu T, Wang Y, Lin L, Tang W. The mediating role of daytime sleepiness between problematic smartphone use and post-traumatic symptoms in COVID-19 home-refined adolescents. CHILDREN AND YOUTH SERVICES REVIEW 2021; 126:106012. [PMID: 33846662 PMCID: PMC8028598 DOI: 10.1016/j.childyouth.2021.106012] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Revised: 01/23/2021] [Accepted: 04/06/2021] [Indexed: 02/08/2023]
Abstract
Background COVID-19 was first recognized in late 2019 in China, at which time school closures forced most students to isolate at home or maintain social distance, both of which increased smartphone use, daytime sleepiness and post traumatic disorder (PTSD) risks. However, to date, no research has fully explored these behavioral risks or the consequences. Methods Two thousand and ninety home-confined students from two Chinese high schools participated in an online-based questionnaire battery that assessed their sociodemographic characteristics, COVID-19 related exposures, daytime sleepiness, problematic smartphone use, and PTSD. The subsequent data were subjected to mediation analysis, and structural equation models (SEM) were employed to explore the variable relationships. Results The problematic smartphone use, daytime sleepiness and PTSD prevalence were respectively 16.4%, 20.2% and 6.9%. The number of COVID-19 related exposure was directly associated with problematic smartphone use and PTSD symptoms. Problematic smartphone use was found to be a mediator between COVID-19 related exposure and PTSD symptoms, and daytime sleepiness was found to partially mediate the associations between problematic smartphone use and PTSD. Conclusions The more exposure associated with the pandemic, the more psychological and behavioral problems the adolescents had. The relatively high rate of problematic smartphone use in home isolated adolescents possibly increased the risk of daytime sleepiness and psychological problems. Therefore, targeted improvements are needed to reduce the risk of psychological problems and daytime sleepiness in adolescents.
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Affiliation(s)
- Tao Hu
- Department of Psychology, Chengdu Normal University, Chengdu, China
| | - Ying Wang
- Department of Psychology, Chengdu Normal University, Chengdu, China
| | - Ling Lin
- Department of Psychology, Chengdu Normal University, Chengdu, China
| | - Wanjie Tang
- Centre for Educational and Health Psychology, Sichuan University, Chengdu, China.,Mental Health Center, State Key Lab of Biotherapy, West China Hospital, Sichuan University, Chengdu, China
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14
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Ben-Ezra M, Hou WK, Goodwin R. Investigating the relationship between COVID-19-related and distress and ICD-11 adjustment disorder: two cross-sectional studies. BJPsych Open 2021; 7:e21. [PMID: 34192043 PMCID: PMC7844155 DOI: 10.1192/bjo.2020.158] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2020] [Revised: 11/21/2020] [Accepted: 11/26/2020] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND To assess the prevalence of elevated risk of serious mental illness and probable ICD-11 adjustment disorder in the UK population at two time points during COVID-19, and their association with COVID-19-related stressful events. AIMS To check the dose-response model for stress between the number of COVID-19-related stressful events and mental health indices. METHOD We conducted two cross-sectional studies, using internet survey samples across the UK (N = 1293 for study 1; N = 1073 for study 2). Samples used internet panel surveys during March-April 2020 and 3 months later (June 2020), and used random stratified samples. Studies assessed prevalence of serious risk of mental illness and probable ICD-11 adjustment disorder. RESULTS Elevated risk of serious mental illness was found among those with COVID-19-related social life or occupationally stressful events (study 1). Elevated risk of serious mental illness and probable ICD-11 adjustment disorder was evident among those reporting COVID-19-related stressful events (personal health problems and caregiving; study 2). Cumulative COVID-19-related stressful events were associated with elevated risk of serious mental illness in study 1 (odds ratio 1.65; 95% CI 1.03-2.64; P = 0.037), and with both elevated risk of serious mental illness (odds ratio 2.19; 95% CI 1.15-4.15; P = 0.017) and probable ICD-11 adjustment disorder (odds ratio 2.45; 95% CI 1.27-4.72; P = 0.007) in study 2. CONCLUSIONS Psychiatrists should be aware that COVID-19-related stressful events can lead to serious psychological problems. Mental health professionals need to pay particular attention to patients who report cumulative COVID-19-related stressful events, and consider them for mental health assessment and treatment.
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Affiliation(s)
| | - Wai Kai Hou
- Department of Psychology, Centre for Psychosocial Health, The Education University of Hong Kong, Hong Kong, China
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15
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Carlson HN, Weiner JL. The neural, behavioral, and epidemiological underpinnings of comorbid alcohol use disorder and post-traumatic stress disorder. INTERNATIONAL REVIEW OF NEUROBIOLOGY 2020; 157:69-142. [PMID: 33648676 DOI: 10.1016/bs.irn.2020.09.006] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Alcohol use disorder (AUD) and (PTSD) frequently co-occur and individuals suffering from this dual diagnosis often exhibit increased symptom severity and poorer treatment outcomes than those with only one of these diseases. Although there have been significant advances in our understanding of the neurobiological mechanisms underlying each of these disorders, the neural underpinnings of the comorbid condition remain poorly understood. This chapter summarizes recent epidemiological findings on comorbid AUD and PTSD, with a focus on vulnerable populations, the temporal relationship between these disorders, and the clinical consequences associated with the dual diagnosis. We then review animal models of the comorbid condition and emerging human and non-human animal research that is beginning to identify maladaptive neural changes common to both disorders, primarily involving functional changes in brain reward and stress networks. We end by proposing a neural framework, based on the emerging field of affective valence encoding, that may better explain the epidemiological and neural findings on AUD and PTSD.
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Affiliation(s)
- Hannah N Carlson
- Department of Physiology and Pharmacology, Wake Forest School of Medicine, Winston-Salem, NC, United States
| | - Jeff L Weiner
- Department of Physiology and Pharmacology, Wake Forest School of Medicine, Winston-Salem, NC, United States.
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16
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Pohane PU, Jaiswal SV, Vahia VN, Sinha D. Psychopathology, perceived social support, and coping in survivors of adult sexual assault: A cross-sectional hospital-based study. Indian J Psychiatry 2020; 62:718-722. [PMID: 33896980 PMCID: PMC8052890 DOI: 10.4103/psychiatry.indianjpsychiatry_432_19] [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: 07/20/2019] [Revised: 10/05/2019] [Accepted: 09/17/2020] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Adult sexual assault (ASA) is often associated with negative mental health consequences. The psychological needs of ASA survivors are overlooked while the legal and social needs focused on. METHODOLOGY It is a cross-sectional study. The ASA survivors who came for medical evaluation were included in the study after obtaining consent. Fifty ASA survivors were interviewed for the study. Psychopathology, perceived social support, and coping mechanisms were assessed during interview using especially designed semi-structured pro forma. RESULTS The mean age of participants was 25.6 ± 7.2 years. Forty-one of 50 survivors suffered from major depressive disorder or posttraumatic stress disorder or both with 33 expressing suicidal ideas. Maximum social support was perceived from family and least from significant others such as health-care workers, police, and judiciary. Problem solving and expressive action are associated with better perceived social support by family as well as friends. CONCLUSION Depression and suicidal ideas among majority the survivors of ASA highlight the mental devastation the sexual assault causes to a woman. Although family is primary social support to them, health-care workers and law enforcement officials are not perceived as supportive toward the survivors. Routine mental health assistance and empathetic approach by all parties involved in the management of survivors are needed in these cases.
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Affiliation(s)
- Pranav U. Pohane
- Department of Psychiatry, Seth G.S. Medical College and K.E.M. Hospital, Nagpur, Maharashtra, India
| | - Suyog Vijay Jaiswal
- Department of Psychiatry, All India Institute of Medical Sciences, Nagpur, Maharashtra, India
| | - Vihang N. Vahia
- Department of Psychiatry, H. B. T. Medical College and Dr. R. N. Cooper Municipal General Hospital, Mumbai, Maharashtra, India
| | - Deoraj Sinha
- Department of Psychiatry, H. B. T. Medical College and Dr. R. N. Cooper Municipal General Hospital, Mumbai, Maharashtra, India
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17
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Jaye Capretto J. Developmental Timing of Childhood Physical and Sexual Maltreatment Predicts Adult Depression and Post-Traumatic Stress Symptoms. JOURNAL OF INTERPERSONAL VIOLENCE 2020; 35:2558-2582. [PMID: 29294721 DOI: 10.1177/0886260517704963] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Child physical and sexual maltreatment have emerged as documented risk factors for a wide range of health problems in adulthood, including depression and post-traumatic stress symptoms. Prior research focuses on generalized childhood adversities without accounting for how different critical details about the maltreatment may affect outcomes in adulthood. The present study examines the impact of two critical details, timing and type of child maltreatment, on depression and post-traumatic stress symptoms in adulthood. Participants (N = 104) completed the Maltreatment and Abuse Chronology of Exposure scale (MACE) and the Inventory of Depression and Anxiety Scale-Second Version (IDAS-II). Hierarchical multiple regressions compared three different models of child maltreatment predictors and their differential utility for predicting depression and post-traumatic stress symptoms in adulthood: (a) number of child maltreatment experiences, (b) severity of child maltreatment, and (c) timing of child maltreatment. Results indicate that severity of child maltreatment and timing of child maltreatment are greater predictors for adult depression and post-traumatic stress symptoms than number of child maltreatment experiences. Compared with other developmental periods, early childhood sexual maltreatment experiences (5 years of age and below) and late childhood physical maltreatment experiences (13 years of age and above) were stronger predictors of adult depression and post-traumatic stress symptoms. Children maltreated during these age groups may be prioritized for prevention and intervention efforts, particularly when there are limited resources. Clinical interviews with maltreated children should also be expanded to include information about developmental timing and severity of maltreatment, which have ramifications for later health problems. Implications for assessment of maltreated children, prevention of adult depression and post-traumatic stress symptoms, and future research directions are discussed.
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18
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Winders S, Murphy O, Looney K, O'Reilly G. Self‐compassion, trauma, and posttraumatic stress disorder: A systematic review. Clin Psychol Psychother 2020; 27:300-329. [DOI: 10.1002/cpp.2429] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2019] [Revised: 01/12/2020] [Accepted: 01/13/2020] [Indexed: 12/11/2022]
Affiliation(s)
- Sarah‐Jane Winders
- Department of Clinical PsychologyUniversity College Dublin Dublin Ireland
| | - Orlagh Murphy
- Department of Clinical PsychologyUniversity College Dublin Dublin Ireland
| | - Kathy Looney
- Department of Clinical PsychologyUniversity College Dublin Dublin Ireland
| | - Gary O'Reilly
- Department of Clinical PsychologyUniversity College Dublin Dublin Ireland
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19
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Killikelly C, Lorenz L, Bauer S, Mahat-Shamir M, Ben-Ezra M, Maercker A. Prolonged grief disorder: Its co-occurrence with adjustment disorder and post-traumatic stress disorder in a bereaved Israeli general-population sample. J Affect Disord 2019; 249:307-314. [PMID: 30797123 DOI: 10.1016/j.jad.2019.02.014] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2018] [Revised: 01/18/2019] [Accepted: 02/05/2019] [Indexed: 12/20/2022]
Abstract
BACKGROUND Prolonged grief disorder (PGD) is a new disorder included in the WHO International Classification of Diseases 11th version (ICD-11). This study is the first to use these new ICD-11 PGD guidelines to examine prevalence rates, predictors of PGD and disorder co-occurrence with other stress-related disorders in a survey of 544 bereaved Israelis. METHODS Descriptive statistics, correlation, linear regression and mediation analysis examined the validity of the ICD-11 diagnostic algorithm. RESULTS Prevalence of PGD in the Israeli population sample is low (2%). The prevalence rate of post-traumatic stress disorder (PTSD) was 7.2% and for adjustment disorder (AjD) was 17.8%. A significant positive correlation found between scores on these measures indicates concurrent validity. Mediation analysis found that symptoms of PGD were predicted by serious life events, and significantly mediated by symptoms of PTSD and AjD. A regression analysis found significant predictors of PGD symptom severity, including socio-demographic and person-specific predictors. LIMITATIONS This study did not assess the index-death of the grief questionnaire. No conclusions could be made regarding the relationship between the type of loss and grief severity. Furthermore, the time since loss (time criterion) was not assessed. CONCLUSIONS This study is the first to examine prevalence rates of ICD-11 PGD in a population-based survey. The mediation relationship between serious life events, AjD, PTSD and PGD supports a vulnerability model of stress related disorders whereby the number of stressful life events may predict symptoms of stress related disorders.
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Affiliation(s)
- Clare Killikelly
- University of Zürich, Department of Psychology, Division Psychopathology and Clinical Intervention, CH-8050 Zürich, Switzerland.
| | - Louisa Lorenz
- University of Zürich, Department of Psychology, Division Psychopathology and Clinical Intervention, CH-8050 Zürich, Switzerland; Klinik im Hasel, Stationäre Therapie, Gontenschwil, Switzerland
| | - Susanna Bauer
- University of Zürich, Department of Psychology, Division Psychopathology and Clinical Intervention, CH-8050 Zürich, Switzerland
| | | | | | - Andreas Maercker
- University of Zürich, Department of Psychology, Division Psychopathology and Clinical Intervention, CH-8050 Zürich, Switzerland
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20
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Jaffe AE, Blayney JA, Bedard-Gilligan M, Kaysen D. Are trauma memories state-dependent? Intrusive memories following alcohol-involved sexual assault. Eur J Psychotraumatol 2019; 10:1634939. [PMID: 31448064 PMCID: PMC6691878 DOI: 10.1080/20008198.2019.1634939] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2019] [Revised: 05/30/2019] [Accepted: 06/07/2019] [Indexed: 11/16/2022] Open
Abstract
Background: Sexual assault (SA) frequently occurs under the influence of alcohol, and is often followed by both drinking and posttraumatic stress symptoms, including intrusive memories. Although many theories attempt to explain the co-occurrence of alcohol use and posttraumatic stress, one possibility not yet considered is that SA memories may be more likely to occur when there is an encoding-retrieval match in alcohol intoxication state. Objective: The aim of this study was to examine the potential for intrusive memories of SA to be state-dependent, such that intrusive memories for alcohol-involved SA may be more likely to occur in the context of subsequent alcohol intoxication. Method: Participants were 100 college women (age range = 18 to 24 years; 73% White/Caucasian, 89% heterosexual) with a history of alcohol-involved SA (67%) or other, non-alcohol-involved SA (33%). Participants completed daily questionnaires for 30 days assessing past-day drinking and intrusion symptoms. Results: A random-intercept, negative binomial multilevel model revealed that, after controlling for overall frequency of drinking and perceived threat during SA, women with a history of alcohol-involved SA reported more severe intrusion symptoms on drinking days than on non-drinking days. No such difference in intrusions was observed for women who were not intoxicated at the time of the assault. Conclusions: Findings are consistent with the possibility of state-dependent intrusive memories. Additional research is needed to determine whether alcohol intoxication might serve as a discriminative cue preceding intrusive memories of alcohol-involved SA.
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Affiliation(s)
- Anna E Jaffe
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, USA
| | - Jessica A Blayney
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, USA
| | - Michele Bedard-Gilligan
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, USA
| | - Debra Kaysen
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, USA
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21
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Hawn SE, Lind MJ, Conley A, Overstreet CM, Kendler KS, Dick DM, Amstadter AB. Effects of social support on the association between precollege sexual assault and college-onset victimization. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2018; 66:467-475. [PMID: 29405876 PMCID: PMC6078834 DOI: 10.1080/07448481.2018.1431911] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/31/2017] [Revised: 09/06/2017] [Accepted: 10/31/2017] [Indexed: 06/07/2023]
Abstract
OBJECTIVE This study examined the moderating and mediating effects of perceived social support on the association between precollege sexual assault (SA) and college-onset SA. PARTICIPANTS A representative sample of 6,132 undergraduates. METHODS The PLUM procedure in SPSS was used to test the moderation model, with individual regressions conducted in a hierarchical fashion. A weighted least squared mean and variance adjusted (WLSMV) mediation model was used to examine the mediating effect of social support. RESULTS Precollege SA significantly predicted college-onset SA. Social support significantly mediated the relation between precollege SA and college-onset SA. Social support was not a significant moderator of this relationship. CONCLUSIONS Given the high prevalence of SA among college populations, as well as the high rates of SA revictimization, identification of factors that may be related to repeated SA (eg, low social support) within this population are essential and may inform intervention, policy, and university student services.
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Affiliation(s)
- Sage E Hawn
- a Department of Psychiatry , Virginia Institute of Psychiatric and Behavioral Genetics, Virginia Commonwealth University , Richmond , Virginia , USA
- b Department of Psychology , Virginia Commonwealth University , Richmond , Virginia , USA
| | - Mackenzie J Lind
- a Department of Psychiatry , Virginia Institute of Psychiatric and Behavioral Genetics, Virginia Commonwealth University , Richmond , Virginia , USA
| | - Abigail Conley
- c Department of Counseling and Special Education , Virginia Commonwealth University , Richmond , Virginia , USA
| | - Cassie M Overstreet
- a Department of Psychiatry , Virginia Institute of Psychiatric and Behavioral Genetics, Virginia Commonwealth University , Richmond , Virginia , USA
- b Department of Psychology , Virginia Commonwealth University , Richmond , Virginia , USA
| | - Kenneth S Kendler
- a Department of Psychiatry , Virginia Institute of Psychiatric and Behavioral Genetics, Virginia Commonwealth University , Richmond , Virginia , USA
- d Department of Human and Molecular Genetics , Virginia Commonwealth University , Richmond , Virginia , USA
| | - Danielle M Dick
- b Department of Psychology , Virginia Commonwealth University , Richmond , Virginia , USA
- d Department of Human and Molecular Genetics , Virginia Commonwealth University , Richmond , Virginia , USA
| | - Ananda B Amstadter
- a Department of Psychiatry , Virginia Institute of Psychiatric and Behavioral Genetics, Virginia Commonwealth University , Richmond , Virginia , USA
- b Department of Psychology , Virginia Commonwealth University , Richmond , Virginia , USA
- d Department of Human and Molecular Genetics , Virginia Commonwealth University , Richmond , Virginia , USA
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Greene T, Gelkopf M, Grinapol S, Werbeloff N, Carlson E, Lapid L. Trajectories of traumatic stress symptoms during conflict: A latent class growth analysis. J Affect Disord 2017; 220:24-30. [PMID: 28577426 DOI: 10.1016/j.jad.2017.05.036] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2017] [Revised: 04/24/2017] [Accepted: 05/23/2017] [Indexed: 11/25/2022]
Abstract
BACKGROUND The ways in which traumatic stress symptoms unfold under situations of ongoing threat and trauma exposure are poorly understood. The current study aims to identify traumatic stress symptom trajectories during conflict, as well as potential risk factors. METHODS Experience sampling methods were used to study traumatic stress symptoms during the 2014 Israel-Gaza conflict in 100 Israeli civilians exposed to rocket fire. Summary reports of traumatic symptoms were made twice-daily for 30 days via mobile phone. RESULTS Latent class growth analysis revealed four distinct classes (low, reducing, moderate, and high) characterised by their trajectory of traumatic stress symptoms during the conflict. Female gender, not being in a relationship, and higher prior trauma exposure were identified as potential risk factors. LIMITATIONS Data were not collected in the early phase of the conflict, the sample was relatively small, and only traumatic stress symptoms were investigated as outcomes. CONCLUSIONS This study identified heterogeneous traumatic stress symptom trajectories among civilians during a conflict, with different subgroups showing distinct response patterns over time, associated with various risk factors. Investigating responses to ongoing trauma, and identifying predictors of different stress symptom trajectories has clinical implications for the targeted delivery of interventions. Further exploration of heterogeneous trajectories could potentially elucidate mechanisms that drive resilience and recovery, including in situations of ongoing exposure such as during conflict.
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Affiliation(s)
- T Greene
- The Department of Community Mental Health, University of Haifa, 199 Aba Houshy Ave, Haifa, Israel.
| | - M Gelkopf
- The Department of Community Mental Health, University of Haifa, 199 Aba Houshy Ave, Haifa, Israel; NATAL, Israel Trauma Center for Victims of Terror and War, Tel Aviv, Israel
| | - S Grinapol
- The Department of Community Mental Health, University of Haifa, 199 Aba Houshy Ave, Haifa, Israel
| | - N Werbeloff
- Division of Psychiatry, University College London, UK
| | - E Carlson
- National Center for PTSD and VA Palo Alto Health Care System, Dept. of Veterans Affairs, USA
| | - L Lapid
- The Department of Community Mental Health, University of Haifa, 199 Aba Houshy Ave, Haifa, Israel; NATAL, Israel Trauma Center for Victims of Terror and War, Tel Aviv, Israel
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Bailey KA, Baker AL, McElduff P, Jones MA, Oldmeadow C, Kavanagh DJ. Effects of Assault Type on Cognitive Behaviour Therapy for Coexisting Depression and Alcohol Misuse. J Clin Med 2017; 6:jcm6070072. [PMID: 28753976 PMCID: PMC5532580 DOI: 10.3390/jcm6070072] [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: 06/07/2017] [Revised: 07/11/2017] [Accepted: 07/17/2017] [Indexed: 11/16/2022] Open
Abstract
Although assault exposure is common in mental health and substance misusing populations, screening for assaults in treatment settings is frequently overlooked. This secondary analysis explored the effects of past sexual (SA) and physical (PA) assault on depression, alcohol misuse, global functioning and attrition in the Depression and Alcohol Integrated and Single focussed Intervention (DAISI) project, whose participants (N = 278) received cognitive behaviour therapy (CBT) for their depression and/or alcohol misuse. Of the 278 DAISI participants, 220 consented to screening for past assault (either by a stranger or non-stranger) at baseline. Depression, alcohol, and global functioning assessments were administered at baseline and 3, 12, 24, and 36 months post baseline. A between-group analysis was used to assess differences between SA and No SA, and PA and No PA groupings, on adjusted mean treatment outcomes across all assessment periods. SA and PA participants had similar mean symptom reductions compared to No SA and No PA participants except for lower depression and global functioning change scores at the 12-month follow-up. People with coexisting depression and alcohol misuse reporting SA or PA can respond well to CBT for depression and alcohol misuse. However, follow-up is recommended in order to monitor fluctuations in outcomes.
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Affiliation(s)
- Kylie A Bailey
- School of Medicine and Public Health, University of Newcastle, University Drive, Callaghan NSW 2308, Australia.
| | - Amanda L Baker
- School of Medicine and Public Health, University of Newcastle, University Drive, Callaghan NSW 2308, Australia.
| | - Patrick McElduff
- School of Medicine and Public Health, University of Newcastle, University Drive, Callaghan NSW 2308, Australia.
| | - Mark A Jones
- Hunter Medical Research Institute, 1/1 Kookaburra circuit, New Lambton Heights NSW 2305, Australia.
| | - Christopher Oldmeadow
- School of Medicine and Public Health, University of Newcastle, University Drive, Callaghan NSW 2308, Australia.
- Hunter Medical Research Institute, 1/1 Kookaburra circuit, New Lambton Heights NSW 2305, Australia.
| | - David J Kavanagh
- Centre for Children's Health Research, Institute of Health & Biomedical Innovation and School of Psychology & Counselling, Queensland University of Technology, GPO Box 2434, Brisbane QLD 4000, Australia.
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Resilience to Interpersonal Trauma and Decreased Risk for Psychopathology in an Epidemiologic Sample. JOURNAL OF PSYCHOPATHOLOGY AND BEHAVIORAL ASSESSMENT 2017. [DOI: 10.1007/s10862-017-9601-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Mgoqi-Mbalo N, Zhang M, Ntuli S. Risk factors for PTSD and depression in female survivors of rape. PSYCHOLOGICAL TRAUMA-THEORY RESEARCH PRACTICE AND POLICY 2017; 9:301-308. [PMID: 28114775 DOI: 10.1037/tra0000228] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE To investigate association of the sociodemographic factors, characteristics of rape and social support to the development of depression and posttraumatic stress disorder at 6 months after the rape. METHOD A cross-sectional survey with female survivors of rape was carried out in 3 provinces of South Africa 6 months after the rape. RESULTS One hundred female survivors s of sexual assault were interviewed. More than half (53%) were from Limpopo, 25% from Western Cape, and 22% from KwaZulu-Natal (KZN). 87% reported high levels of PTSD and 51% moderate to severe depression post rape. The major risk factors for PTSD and depression were the unmarried survivors of rape and those living in KZN. The female survivors of rape in KZN province were 7 times more likely to experience symptoms of depression compared to other provinces, while married/cohabiting female rape survivors were 6 times less likely to report symptoms of depression compared to the unmarried female rape survivors. CONCLUSION These findings add support to existing literature on PTSD and depression as common mental health consequence of rape and also provide evidence that survivors' socio- demographics-marital status, employment status-are significant contributors to the development of symptoms of depression and PTSD after rape. The results have research and clinical practice relevance for ensuring that PTSD and trauma treatment focuses on an in-depth understanding of the various aspects of the sociodemographic factors and rape characteristics that contribute to survivors' mental state and how these compound stress and depression symptoms over time post rape victimization. (PsycINFO Database Record
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Affiliation(s)
| | - Muyu Zhang
- Semel Institute for Neuroscience and Human Behavior, University of California
| | - Sam Ntuli
- Department of Psychology, University of Limpopo (Polokwane Campus)
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Conley AH, Overstreet CM, Hawn SE, Kendler KS, Dick DM, Amstadter AB. Prevalence and predictors of sexual assault among a college sample. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2017; 65:41-49. [PMID: 27628533 PMCID: PMC5862547 DOI: 10.1080/07448481.2016.1235578] [Citation(s) in RCA: 52] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
OBJECTIVE This study examined the prevalence and correlates of precollege, college-onset, and repeat sexual assault (SA) within a representative student sample. PARTICIPANTS A representative sample of 7,603 students. METHODS Incoming first-year students completed a survey about their exposure to broad SA prior to college, prior trauma, personality, relationships, and mental health. Broad SA was then reassessed each spring semester while enrolled. RESULTS Nearly 20% of the sample reported experiencing broad SA, with women endorsing significantly higher rates compared with males. Prior victimization before coming to college was related to a greater risk of victimization in college, and there was no statistically significant difference between males and females who reported revictimization. Correlates of college-onset broad SA were found and are discussed. CONCLUSIONS Given the need for SA intervention and prevention on college campuses, identification of factors potentially contributing to exposure within this population is essential.
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Affiliation(s)
- A H Conley
- a Department of Counselor Education , Virginia Commonwealth University , Richmond , Virginia , USA
| | - C M Overstreet
- b Department of Psychiatry , Virginia Institute of Psychiatric and Behavioral Genetics, Virginia Commonwealth University , Richmond , Virginia , USA
| | - S E Hawn
- b Department of Psychiatry , Virginia Institute of Psychiatric and Behavioral Genetics, Virginia Commonwealth University , Richmond , Virginia , USA
| | - K S Kendler
- b Department of Psychiatry , Virginia Institute of Psychiatric and Behavioral Genetics, Virginia Commonwealth University , Richmond , Virginia , USA
- c Department of Human and Molecular Genetics , Virginia Commonwealth University , Richmond , Virginia , USA
| | - D M Dick
- b Department of Psychiatry , Virginia Institute of Psychiatric and Behavioral Genetics, Virginia Commonwealth University , Richmond , Virginia , USA
| | - A B Amstadter
- b Department of Psychiatry , Virginia Institute of Psychiatric and Behavioral Genetics, Virginia Commonwealth University , Richmond , Virginia , USA
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Overstreet C, Berenz EC, Kendler KS, Dick DM, Amstadter AB. Predictors and mental health outcomes of potentially traumatic event exposure. Psychiatry Res 2017; 247:296-304. [PMID: 27940325 PMCID: PMC5921931 DOI: 10.1016/j.psychres.2016.10.047] [Citation(s) in RCA: 43] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2015] [Revised: 04/27/2016] [Accepted: 10/24/2016] [Indexed: 11/25/2022]
Abstract
The aims were two-fold: to examine prevalence and correlates of lifetime potentially traumatic event (PTE) exposure and to explore the relationships between PTE exposure and mental health outcomes (i.e., trauma related distress, alcohol use quantity and frequency, depression symptoms, and anxiety symptoms) within a large sample of college freshmen. 6120 participants, consisting of three cohorts of incoming freshman at a large southeastern university, completed an online assessment battery measuring a multitude of factors including PTEs, personality, relationships (i.e., parental and peer), and mental health. The majority (81.8%) of participants endorsed experiencing at least one PTE within their lifetime and 39.0% reported at least one interpersonal trauma (i.e., physical assault, sexual assault, other unwanted or uncomfortable sexual situation). The average number of PTE categories endorsed was 1.71 (SD=1.30), and 8.7% of participants reported experiencing four or more separate PTE categories pre-college entry. Female gender and peer deviance were consistently associated with PTE exposure and symptoms of psychopathology. Furthermore, a history of interpersonal PTE exposure was associated with increased alcohol use (i.e., frequency and quantity), trauma related distress, depressive symptoms, and anxiety symptoms. The data demonstrate high prevalence PTE exposure among young adults and the clinical significance of a PTE history.
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Affiliation(s)
- Cassie Overstreet
- Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University, Richmond, VA, USA.
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Overstreet C, Berenz EC, Sheerin C, Amstadter AB, Canino G, Silberg J. Potentially Traumatic Events, Posttraumatic Stress Disorder, and Depression among Adults in Puerto Rico. Front Psychol 2016; 7:469. [PMID: 27064295 PMCID: PMC4815006 DOI: 10.3389/fpsyg.2016.00469] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2015] [Accepted: 03/16/2016] [Indexed: 11/13/2022] Open
Abstract
The aims of the current study were to examine the prevalence of potentially traumatic events (PTEs), posttraumatic stress disorder (PTSD; data available in males only), and depressive symptoms in a Puerto Rican sample of 678 adult caretakers (50% female) of twins participating in the Puerto Rican Infant Twin Study. The World Health Organization Composite International Diagnostic Interview version 3.0 (CIDI 3.0) was utilized to assess rates of PTEs, PTSD, and depression among male participants while an abbreviated version of the CIDI 3.0 and the Mood and Feelings Questionnaire were administered to females to assess PTEs and depressive symptoms. Significantly more males than females reported exposure to a PTE (76.6% vs. 44.2%, χ(2) = 64.44, p < 0.001). In males, endorsement of multiple PTEs was associated with increased level of PTSD symptomatology (β = 0.33, p < 0.001). With regard to depression, a similar dose-response relationship was found in both males and females, with depressive symptoms increasing as number of PTEs increased (βs = 0.15, 0.16, ps < 0.05). Exposure to an attack with a weapon was significantly associated with increased depression symptoms in both males and females (βs = 0.24, 0.20, ps < 0.01, respectively). These findings highlight the need for identification of putative risk and resilience factors among PTE-exposed individuals in Puerto Rico.
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Affiliation(s)
- Cassie Overstreet
- Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University, Richmond VA, USA
| | - Erin C Berenz
- Developmental Pediatrics, University of Virginia, Charlottesville VA, USA
| | - Christina Sheerin
- Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University, Richmond VA, USA
| | - Ananda B Amstadter
- Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University, Richmond VA, USA
| | - Glorisa Canino
- Behavioral Sciences Research Institute, University of Puerto Rico, San Juan PR, USA
| | - Judy Silberg
- Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University, Richmond VA, USA
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Boroughs MS, Valentine SE, Ironson GH, Shipherd JC, Safren SA, Taylor SW, Dale SK, Baker JS, Wilner JG, O'Cleirigh C. Complexity of childhood sexual abuse: predictors of current post-traumatic stress disorder, mood disorders, substance use, and sexual risk behavior among adult men who have sex with men. ARCHIVES OF SEXUAL BEHAVIOR 2015; 44:1891-902. [PMID: 26159863 PMCID: PMC4853755 DOI: 10.1007/s10508-015-0546-9] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/11/2014] [Revised: 04/07/2015] [Accepted: 04/10/2015] [Indexed: 05/16/2023]
Abstract
Men who have sex with men (MSM) are the group most at risk for HIV and represent the majority of new infections in the United States. Rates of childhood sexual abuse (CSA) among MSM have been estimated as high as 46 %. CSA is associated with increased risk of HIV and greater likelihood of HIV sexual risk behavior. The purpose of this study was to identify the relationships between CSA complexity indicators and mental health, substance use, sexually transmitted infections, and HIV sexual risk among MSM. MSM with CSA histories (n = 162) who were screened for an HIV prevention efficacy trial completed comprehensive psychosocial assessments. Five indicators of complex CSA experiences were created: CSA by family member, CSA with penetration, CSA with physical injury, CSA with intense fear, and first CSA in adolescence. Adjusted regression models were used to identify relationships between CSA complexity and outcomes. Participants reporting CSA by family member were at 2.6 odds of current alcohol use disorder (OR 2.64: CI 1.24-5.63), two times higher odds of substance use disorder (OR 2.1: CI 1.02-2.36), and 2.7 times higher odds of reporting an STI in the past year (OR 2.7: CI 1.04-7.1). CSA with penetration was associated with increased likelihood of current PTSD (OR 3.17: CI 1.56-6.43), recent HIV sexual risk behavior (OR 2.7: CI 1.16-6.36), and a greater number of casual sexual partners (p = 0.02). Both CSA with Physical Injury (OR 4.05: CI 1.9-8.7) and CSA with Intense Fear (OR 5.16: CI 2.5-10.7) were related to increased odds for current PTSD. First CSA in adolescence was related to increased odds of major depressive disorder. These findings suggest that CSA, with one or more complexities, creates patterns of vulnerabilities for MSM, including post-traumatic stress disorder, substance use, and sexual risk taking, and suggests the need for detailed assessment of CSA and the development of integrated HIV prevention programs that address mental health and substance use comorbidities.
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Affiliation(s)
- Michael S. Boroughs
- Department of Psychiatry, Massachusetts General Hospital
- Harvard Medical School
| | - Sarah E. Valentine
- Department of Psychiatry, Massachusetts General Hospital
- Harvard Medical School
| | | | - Jillian C. Shipherd
- VA Boston Healthcare System, National Center for PTSD – Women's Health Sciences Division and Boston University School of Medicine
| | - Steven A. Safren
- Department of Psychiatry, Massachusetts General Hospital
- Harvard Medical School
- The Fenway Institute, Fenway Health
| | | | - Sannisha K. Dale
- Department of Psychiatry, Massachusetts General Hospital
- Harvard Medical School
| | | | | | - Conall O'Cleirigh
- Department of Psychiatry, Massachusetts General Hospital
- Harvard Medical School
- The Fenway Institute, Fenway Health
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Logan TK, Walker R, Cole J. Silenced suffering: the need for a better understanding of partner sexual violence. TRAUMA, VIOLENCE & ABUSE 2015; 16:111-135. [PMID: 24379191 DOI: 10.1177/1524838013517560] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
This article has two overall goals. First, to examine the current state of sexual violence research to highlight several shortcomings in the knowledge on partner sexual violence. Second, to describe several factors to consider in future research to facilitate a more in-depth understanding of partner sexual violence. Shortcomings of the research on partner sexual violence include (1) overreliance on dichotomous yes/no representations of sexual violence experiences; (2) lack of, or inadequate documentation of the scope and nature of partner sexual violence; (3) inadequate ways to account for impairment of consent under different circumstances; (4) difficulties in discriminating unwanted from nonconsensual sexual activities; and (5) limited information about the role sexual violence plays in the larger context of coercive control. In order to facilitate a more in-depth understanding of partner sexual assault, there is a need (1) to better understand the scope and nature of partner sexual assault and (2) to better understand the role partner sexual violence plays in coercive control. By improving the measurement of this phenomenon, victims, researchers, practitioners, and those involved in the justice system might be better equipped to respond to sexual violence among intimate partners.
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Affiliation(s)
- T K Logan
- University of Kentucky, Lexington, KY, USA
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Park J, Jun JY, Lee YJ, Kim S, Lee SH, Yoo SY, Kim SJ. The association between alexithymia and posttraumatic stress symptoms following multiple exposures to traumatic events in North Korean refugees. J Psychosom Res 2015; 78:77-81. [PMID: 25248674 DOI: 10.1016/j.jpsychores.2014.09.007] [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: 07/14/2014] [Revised: 09/01/2014] [Accepted: 09/06/2014] [Indexed: 10/24/2022]
Abstract
OBJECTIVE The present study aimed to investigate the effect of the interaction between the number of traumas experienced and alexithymia, on posttraumatic stress disorder (PTSD) symptoms. METHODS The sample comprised 199 North Korean refugees. Participants completed the Trauma Exposure Check List for North Korean Refugees, Impact of Event Scale-Revised (IES-R), Toronto Alexithymia Scale-20 (TAS-20), and Center for Epidemiological Studies-Depression Scale (CES-D). RESULTS TAS-20 scores were positively correlated with IES-R scores (r=0.21, p<0.01), after controlling for gender, age, and CES-D scores. The number of traumas experienced was also positively correlated with IES-R scores (r=0.32, p<0.001), but not with TAS-20 scores, after controlling for gender, age, and CES-D scores. A hierarchical multiple regression analysis revealed a significant interaction between the number of traumas experienced and TAS-20 scores, for IES-R scores (t=2.10, p<0.05). Moderation analysis further revealed that TAS-20 scores moderate the relationship between the number of traumas experienced and IES-R scores (t=2.90, p<0.01). For refugees with higher TAS-20 scores, those who had experienced more traumas had higher IES-R scores. However, within refugees with lower TAS-20 scores, IES-R scores were not significantly different for those who had experienced a higher number of traumas compared with those who had experienced a lower, or average, number of traumas. CONCLUSION The results of the current study suggest that, as individuals experience more traumatic events, clearly identifying and expressing emotions become more crucial for reducing PTSD symptoms.
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Affiliation(s)
- Juhyun Park
- Department of Psychiatry, Seoul National University Hospital, Seoul, Republic of Korea
| | - Jin Yong Jun
- Department of Psychiatry, Settlement Support Center for North Korean Refugee, Ansung, Republic of Korea
| | - Yu Jin Lee
- Department of Psychiatry, Seoul National University Hospital, Seoul, Republic of Korea
| | - Soohyun Kim
- Department of Psychiatry, Seoul National University Hospital, Seoul, Republic of Korea
| | - So-Hee Lee
- Department of Psychiatry, National Medical Center, Seoul, Republic of Korea
| | - So Young Yoo
- Department of Psychiatry, National Medical Center, Seoul, Republic of Korea
| | - Seog Ju Kim
- Department of Psychiatry, Seoul National University Hospital, Seoul, Republic of Korea; Department of Medical Science, Seoul National University College of Medicine, Seoul, Republic of Korea.
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Abstract
A meta-analysis was conducted to examine the dose-response theory as it relates to posttraumatic stress symptoms (PTSSs) following mass shootings. It was hypothesized that greater exposure to a mass shooting would be associated with greater PTSSs. Trauma exposure in the current study was broadly defined as the extent to which a person experienced or learned about a mass shooting. The meta-analysis identified 11 qualifying studies that included 13 independent effect sizes from a total of 8,047 participants. The overall weighted mean effect size, based on a random effects model, was r = .19, p < .001, 95% CI [.13, .25]. Maximum likelihood meta-regressions revealed no significant linear effects of participant gender, participant age, or time elapsed since the shooting on the relationship between exposure and PTSSs. Because so few studies satisfied the inclusion criteria, the present study also documents that this area of the literature is underresearched.
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Affiliation(s)
- Laura C Wilson
- Psychology Department, University of Mary Washington, Fredericksburg, Virginia, USA
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Abstract
Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, has removed criterion A2 from the diagnosis of posttraumatic stress disorder. The current study aimed to assess the claim that criterion A2 has low use in predicting distress, while addressing the shortcomings of previous research looking at criteria A1 and A2. Data from a longitudinal, prospective study was used, with 933 women having been assessed at four time points both prebirth and postbirth. In our sample of women, model comparisons suggest that criterion A2 should be reintroduced into the diagnostic criteria as it provides a better indicator of who goes on to have problems after giving birth than criterion A1 on its own. There is also evidence that this subjective reaction to event confrontation (A2) should include anger, shame, and guilt.
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Somer E, Ruvio A. The Going Gets Tough, So Let's Go Shopping: On Materialism, Coping, and Consumer Behaviors Under Traumatic Stress. JOURNAL OF LOSS & TRAUMA 2014. [DOI: 10.1080/15325024.2013.794670] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Barnes R, Josefowitz N. Forensic Assessment of Adults Reporting Childhood Sexualized Assault: Risk, Resilience, and Impacts. PSYCHOLOGICAL INJURY & LAW 2014. [DOI: 10.1007/s12207-014-9184-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Stratton KJ, Aggen SH, Richardson LK, Berenz EC, Tran TL, Trung LT, Tam NT, Tuan T, Buoi LT, Ha TT, Thach TD, Amstadter AB. Using the SRQ-20 factor structure to examine changes in mental distress following typhoon exposure. Psychol Assess 2014; 26:528-38. [PMID: 24512425 DOI: 10.1037/a0035871] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Empirical research is limited regarding postdisaster assessment of distress in developing nations. This study aimed to evaluate the factor structure of the 20-item Self-Reporting Questionnaire (SRQ-20) before and after an acute trauma, Typhoon Xangsane, in order to examine changes in mental health symptoms in an epidemiologic sample of Vietnamese adults. The study examined a model estimating individual item factor loadings, thresholds, and a latent change factor for the SRQ-20's single "general distress" common factor. The covariates of sex, age, and severity of typhoon exposure were used to evaluate the disaster-induced changes in SRQ-20 scores while accounting for possible differences in the relationship between individual measurement scale items and the latent mental health construct. Evidence for measurement noninvariance was found. However, allowing sex and age effects on the pre-typhoon and post-typhoon factors accounted for much of the noninvariance in the SRQ-20 measurement structure. A test of no latent change failed, indicating that the SRQ-20 detected significant individual differences in distress between pre- and post-typhoon assessment. Conditioning on age and sex, several typhoon exposure variables differentially predicted levels of distress change, including evacuation, personal injury, and peri-event fear. On average, females and older individuals reported higher levels of distress than males and younger individuals, respectively. The SRQ-20 is a valid and reasonably stable instrument that may be used in postdisaster contexts to assess emotional distress and individual changes in mental health symptoms.
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Affiliation(s)
| | - Steven H Aggen
- Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University
| | | | - Erin C Berenz
- Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University
| | | | | | | | - Tran Tuan
- Research and Training Center for Community Development
| | - La Thi Buoi
- Research and Training Center for Community Development
| | - Tran Thu Ha
- Research and Training Center for Community Development
| | | | - Ananda B Amstadter
- Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University
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Thormar SB, Gersons BP, Juen B, Djakababa MN, Karlsson T, Olff M. Organizational factors and mental health in community volunteers. The role of exposure, preparation, training, tasks assigned, and support. ANXIETY STRESS AND COPING 2013. [DOI: 10.1080/10615806.2012.743021] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Berenz EC, Trapp SK, Acierno R, Richardson L, Kilpatrick DG, Tran TL, Trung LT, Tam NT, Tuan T, Buoi LT, Ha TT, Thach TD, Gaboury M, Amstadter AB. Pretyphoon panic attack history moderates the relationship between degree of typhoon exposure and posttyphoon PTSD and depression in a Vietnamese sample. Depress Anxiety 2013; 30:461-8. [PMID: 23495143 PMCID: PMC4068253 DOI: 10.1002/da.22096] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2012] [Revised: 01/03/2013] [Accepted: 02/18/2013] [Indexed: 11/07/2022] Open
Abstract
BACKGROUND Predisaster risk factors are related to postdisaster psychopathology even at relatively low levels of disaster exposure. A history of panic attacks (PA) may convey risk for postdisaster psychopathology and has been linked to a wide range of psychiatric disorders in Western and non-Western samples. The present study examined the main and interactive effects of pretyphoon PA and level of typhoon exposure in the onset of posttyphoon posttraumatic stress disorder (PTSD), major depression (MDD), and generalized anxiety disorder (GAD) in a Vietnamese sample of typhoon survivors. METHODS Typhoon Xangsane interrupted a Vietnamese epidemiological mental health needs assessment, providing a rare opportunity for preand posttyphoon assessments. Hierarchical logistic regression analyses evaluated whether the main and interactive effects of typhoon exposure severity and PA history were significantly related to posttyphoon diagnoses, above and beyond age, health status, pretyphoon psychiatric screening results, and history of potentially traumatic events. RESULTS PA history moderated the relationship between severity of typhoon exposure and posttyphoon PTSD and MDD, but not GAD. Specifically, greater degree of exposure to the typhoon was significantly related to increased likelihood of postdisaster PTSD and MDD among individuals without a history of PA, above and beyond variance accounted for by pretyphoon psychiatric screening results. Individuals with a history of PA evidenced greater risk for postdisaster PTSD and MDD regardless of severity of typhoon exposure. CONCLUSIONS Preexisting PA may affect the nature of the relationship between disaster characteristics and prevalence of postdisaster PTSD and MDD within Vietnamese samples.
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Affiliation(s)
- Erin C Berenz
- Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University, Richmond, VA 23298-0126, USA.
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Chen Y, Fu K, Feng C, Tang L, Zhang J, Huan Y, Cui J, Mu Y, Qi S, Xiong L, Ma C, Wang H, Tan Q, Yin H. Different regional gray matter loss in recent onset PTSD and non PTSD after a single prolonged trauma exposure. PLoS One 2012; 7:e48298. [PMID: 23155380 PMCID: PMC3498281 DOI: 10.1371/journal.pone.0048298] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2012] [Accepted: 09/26/2012] [Indexed: 12/04/2022] Open
Abstract
Objective Gray matter loss in the limbic structures was found in recent onset post traumatic stress disorder (PTSD) patients. In the present study, we measured regional gray matter volume in trauma survivors to verify the hypothesis that stress may cause different regional gray matter loss in trauma survivors with and without recent onset PTSD. Method High resolution T1-weighted magnetic resonance imaging (MRI) were obtained from coal mine flood disaster survivors with (n = 10) and without (n = 10) recent onset PTSD and 20 no trauma exposed normal controls. The voxel-based morphometry (VBM) method was used to measure the regional gray matter volume in three groups, the correlations of PTSD symptom severities with the gray matter volume in trauma survivors were also analyzed by multiple regression. Results Compared with normal controls, recent onset PTSD patients had smaller gray matter volume in left dorsal anterior cingulate cortex (ACC), and non PTSD subjects had smaller gray matter volume in the right pulvinar and left pallidum. The gray matter volume of the trauma survivors correlated negatively with CAPS scores in the right frontal lobe, left anterior and middle cingulate cortex, bilateral cuneus cortex, right middle occipital lobe, while in the recent onset PTSD, the gray matter volume correlated negatively with CAPS scores in bilateral superior medial frontal lobe and right ACC. Conclusion The present study identified gray matter loss in different regions in recent onset PTSD and non PTSD after a single prolonged trauma exposure. The gray matter volume of left dorsal ACC associated with the development of PTSD, while the gray matter volume of right pulvinar and left pallidum associated with the response to the severe stress. The atrophy of the frontal and limbic cortices predicts the symptom severities of the PTSD.
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Affiliation(s)
- Yunchun Chen
- Department of Psychiatry, Xijing Hospital, Fourth Military Medical University, Xi’an, Shaanxi, China
| | - Kuang Fu
- Department of Magnetic Resonance Imaging, The Second Affiliated Hospital, Harbin Medical University, Harbin, Heilongjiang, China
| | - Chen Feng
- Department of Radiology, Xijing Hospital, Fourth Military Medical University, Xi’an, Shaanxi, China
| | - Lihua Tang
- Department of Radiology, PLA General Hospital, Beijing, China
| | - Jian Zhang
- Department of Respiratory Medicine, Xijing Hospital, Fourth Military Medical University, Xi’an, Shaanxi, China
| | - Yi Huan
- Department of Radiology, Xijing Hospital, Fourth Military Medical University, Xi’an, Shaanxi, China
| | - Jinli Cui
- Department of Radiology, Xijing Hospital, Fourth Military Medical University, Xi’an, Shaanxi, China
| | - Yunfeng Mu
- Department of Radiology, Xijing Hospital, Fourth Military Medical University, Xi’an, Shaanxi, China
| | - Shun Qi
- Department of Radiology, Xijing Hospital, Fourth Military Medical University, Xi’an, Shaanxi, China
| | - Lize Xiong
- Department of Anesthesiology, Xijing Hospital, Fourth Military Medical University, Xi’an, Shaanxi, China
| | - Cheng Ma
- Department of Radiology, Xijing Hospital, Fourth Military Medical University, Xi’an, Shaanxi, China
| | - Huaihai Wang
- Department of Psychiatry, Xijing Hospital, Fourth Military Medical University, Xi’an, Shaanxi, China
| | - Qingrong Tan
- Department of Psychiatry, Xijing Hospital, Fourth Military Medical University, Xi’an, Shaanxi, China
- * E-mail: (QT); (HY)
| | - Hong Yin
- Department of Radiology, Xijing Hospital, Fourth Military Medical University, Xi’an, Shaanxi, China
- * E-mail: (QT); (HY)
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Karsberg SH, Lasgaard M, Elklit A. Victimisation and PTSD in a Greenlandic youth sample. Int J Circumpolar Health 2012; 71:IJCH-71-18378. [PMID: 22973570 PMCID: PMC3427974 DOI: 10.3402/ijch.v71i0.18378] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2012] [Revised: 06/08/2012] [Accepted: 07/31/2012] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Despite a growing number of studies and reports indicating a very high and increasing prevalence of trauma exposure in Greenlandic adolescents, the knowledge on this subject is still very limited. The purpose of the present study was twofold: To estimate the lifetime prevalence of potentially traumatic events (PTEs) and post-traumatic stress disorder (PTSD) and to examine the relationship between PTEs, estimated PTSD, and sociodemographic variables. METHODS In a Greenlandic sample from 4 different schools in 2 different minor towns in Northern Greenland, 269 students, aged 12-18 (M=15.4; SD=1.84) were assessed for their level of exposure to 20 PTEs along with the psychological impact of these events. RESULTS Of the Greenlandic students, 86% had been directly exposed to at least 1 PTE and 74.3% had been indirectly exposed to at least 1 PTE. The mean number of directly experienced PTEs was 2.8 and the mean number of indirectly experienced PTEs was 3.9. The most frequent direct events recorded were death of someone close, near drowning, threat of assault/beating, humiliation or persecution by others and attempted suicide. The estimated lifetime prevalence of PTSD was 17.1%, whereas another 14.2% reached a subclinical level of PTSD (missing the full diagnosis by 1 symptom). Education level of the father, and being exposed to multiple direct and indirect PTEs were significantly associated with an increase in PTSD symptoms. CONCLUSION The findings indicate substantial mental health problems in Greenlandic adolescents and that these are associated with various types of PTEs. Furthermore, the findings indicate that Greenlandic adolescents are more exposed to certain specific PTEs than adolescents in similar studies from other nations. The present study revealed that Greenlandic girls are particularly vulnerable towards experiencing PTEs. Indeed, in general, girls reported more experiences of direct and indirect PTEs. Furthermore, girls reported being more commonly exposed to specific types of PTEs compared to boys.
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Affiliation(s)
- Sidsel H Karsberg
- Institute of Psychology, Danish National Centre for Psychotraumatology, University of Southern Denmark, DK-5230 Odense, Denmark.
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Van Loey NE, van de Schoot R, Faber AW. Posttraumatic stress symptoms after exposure to two fire disasters: comparative study. PLoS One 2012; 7:e41532. [PMID: 22911810 PMCID: PMC3404048 DOI: 10.1371/journal.pone.0041532] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2012] [Accepted: 06/24/2012] [Indexed: 02/07/2023] Open
Abstract
This study investigated traumatic stress symptoms in severely burned survivors of two fire disasters and two comparison groups of patients with "non-disaster" burn injuries, as well as risk factors associated with acute and chronic stress symptoms. Patients were admitted to one out of eight burn centers in The Netherlands or Belgium. The Impact of Event Scale (IES) was administered to 61 and 33 survivors respectively of two fire disasters and 54 and 57 patients with "non-disaster" burn etiologies at 2 weeks, 3, 6, 12 and 24 months after the event. We used latent growth modeling (LGM) analyses to investigate the stress trajectories and predictors in the two disaster and two comparison groups. The results showed that initial traumatic stress reactions in disaster survivors with severe burns are more intense and prolonged during several months relative to survivors of "non-disaster" burn injuries. Excluding the industrial fire group, all participants' symptoms on average decreased over the two year period. Burn severity, peritraumatic anxiety and dissociation predicted the long-term negative outcomes only in the industrial fire group. In conclusion, fire disaster survivors appear to experience higher levels of traumatic stress symptoms on the short term, but the long-term outcome appears dependent on factors different from the first response. Likely, the younger age, and several beneficial post-disaster factors such as psychosocial aftercare and social support, along with swift judicial procedures, contributed to the positive outcome in one disaster cohort.
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Affiliation(s)
- Nancy E Van Loey
- Department of Psychosocial and Behavioural Research, Association of Dutch Burns Centres, Beverwijk, The Netherlands.
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Lifetime exposure to traumatic psychological stress is associated with elevated inflammation in the Heart and Soul Study. Brain Behav Immun 2012; 26:642-9. [PMID: 22366689 PMCID: PMC3322304 DOI: 10.1016/j.bbi.2012.02.003] [Citation(s) in RCA: 62] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2011] [Revised: 02/07/2012] [Accepted: 02/08/2012] [Indexed: 11/23/2022] Open
Abstract
Exposure to traumatic psychological stress increases risk for disease events and mortality in patients with cardiovascular disease (CVD). While the biological mechanisms of these effects are not known, inflammation may play a key role as it is both elevated by psychological stress and involved in the development and progression of CVD. In a prospective study of patients with stable CVD (n=979), we examined if higher lifetime trauma exposure was associated with elevated levels of inflammation at baseline and at five-year follow-up, and with greater increases in inflammation over time. Inflammation was indexed by a composite score incorporating the inflammatory markers interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α), C-reactive protein (CRP) and resistin. In follow-up analyses, we adjusted for sociodemographic factors, psychiatric disorders and health behaviors that were significantly associated with trauma exposure. Higher trauma exposure was associated with elevated inflammation at baseline (β=.09, p=.01) and at five-year follow-up (β=.09, p=.03). While levels of inflammation increased from baseline to follow-up in the sample, there was no significant association between trauma exposure and rate of change in inflammation. Findings were robust to adjustments for sociodemographic factors and psychiatric disorders, but health behaviors appeared to contribute to the association between trauma and inflammation at follow-up. This is the first large-scale demonstration of an association between lifetime trauma exposure and inflammation. High lifetime exposure to traumatic stress may contribute to an accelerated rate of CVD progression through elevated inflammation.
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Bowler RM, Harris M, Li J, Gocheva V, Stellman SD, Wilson K, Alper H, Schwarzer R, Cone JE. Longitudinal mental health impact among police responders to the 9/11 terrorist attack. Am J Ind Med 2012; 55:297-312. [PMID: 22213367 DOI: 10.1002/ajim.22000] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/01/2011] [Indexed: 11/07/2022]
Abstract
BACKGROUND Among police responders enrolled in the World Trade Center Health Registry (WTCHR), Post-traumatic Stress Disorder (PTSD) was almost twice as prevalent among women as men 2-3 years after the 9/11 attacks. METHODS Police participants in the WTCHR Wave 1 survey 2-3 years after 9/11/01, were reassessed for probable PTSD at Wave 2, 5-6 years after 9/11/01, using PCL DSM-IV criteria. RESULTS Police participants in the Wave 2 survey included 2,527 men, 413 women. The prevalence of "Probable PTSD" was 7.8% at Wave 1 and 16.5% at Wave 2. Mean PCL scores increased from 25.1 to 29.9 for men and 28.6 to 32.2 for women. Prevalence of PTSD was higher for women than for men at Wave 1 (χ(2) = 10.882, P = 0.002), but not Wave 2 (χ(2) = 2.416, P = 0.133). Other risk factors included losing one's job after 9/11 and being disabled. CONCLUSIONS Prevalence of probable PTSD among police doubled between 2003-2004 and 2006-2007. After the 2-year time span, the gender difference was no longer significant; prevalence of PTSD symptoms increased and there was a substantial amount of co-morbidity with other mental health problems. Further development of prevention and intervention strategies for police responders with symptoms of PTSD is needed. The observed upward trend in PCL scores over time in police officers with PCL scores less than 44, suggests that PTSD prevention and intervention strategies should be applied to all police affected by the 9/11 attacks, not limited just to those with PTSD symptoms.
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Affiliation(s)
- Rosemarie M Bowler
- Department of Psychology, San Francisco State University, California, USA.
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Kira IA, Templin T, Lewandowski L, Ashby JS, Oladele A, Odenat L. Cumulative Trauma Disorder Scale (CTD): Two Studies. ACTA ACUST UNITED AC 2012. [DOI: 10.4236/psych.2012.39099] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Factors associated with mental health utilization among minorities following the second Lebanon war in Israel. Psychiatr Q 2011; 82:297-302. [PMID: 21336609 DOI: 10.1007/s11126-011-9171-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
The purpose of the study was to examine the association between demographics, war-related factors, and psychosocial factors with mental health utilization among minorities in Israel. One thousand and sixty-eight participants filled a battery of self report questionnaires asking about demographics, psychosocial factors and war-related experience during the second Lebanon war, along with measurements of psychiatric symptoms. Logistic regression analyses revealed that injury of a relative during the war increased the probability to utilize mental health services (odds ratio, 3.854; 95% CI, 2.827-5.253). Our results support the importance of psychological first-aid to family members with relatives who were injured during war.
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Bedard-Gilligan M, Kaysen D, Desai S, Lee CM. Alcohol-involved assault: associations with posttrauma alcohol use, consequences, and expectancies. Addict Behav 2011; 36:1076-82. [PMID: 21813246 DOI: 10.1016/j.addbeh.2011.07.001] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2011] [Revised: 06/01/2011] [Accepted: 07/05/2011] [Indexed: 10/18/2022]
Abstract
Victim alcohol consumption is common prior to sexual assault, and a burgeoning literature suggests that victims who were intoxicated during assault may differ in post-assault adjustment compared to those who were not impaired. Less is known about potential relationships between experiencing an alcohol-involved assault (AIA) and later drinking behavior. In this study, we examined the relationships between sexual assault, subsequent drinking behavior and consequences, and alcohol expectancies in a sample of 306 undergraduate women who reported current alcohol use and reported either no trauma history (n=53), non-AIA (n=69), or AIA (n=184). Differences emerged for alcohol use (F(2, 298)=12.78, p<.001), peak blood alcohol content (F(2, 298)=9.66, p<.001), consequences (F(2, 296)=7.38, p<.005), and positive alcohol expectancies (F(14, 796)=1.93, p<.05). In particular, women with an AIA reported greater alcohol use and positive expectancies compared to women with no trauma history and women with a non-alcohol influenced assault. In addition, both assault groups reported greater drinking consequences than women with no trauma history. Findings suggest that it is the women who are assaulted while under the influence of alcohol who evidence more alcohol use and alcohol-related problems following assault.
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Zhang J, Tan Q, Yin H, Zhang X, Huan Y, Tang L, Wang H, Xu J, Li L. Decreased gray matter volume in the left hippocampus and bilateral calcarine cortex in coal mine flood disaster survivors with recent onset PTSD. Psychiatry Res 2011; 192:84-90. [PMID: 21498053 DOI: 10.1016/j.pscychresns.2010.09.001] [Citation(s) in RCA: 78] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2010] [Revised: 09/03/2010] [Accepted: 09/04/2010] [Indexed: 10/18/2022]
Abstract
Although limbic structure changes have been found in chronic and recent onset post-traumatic stress disorder (PTSD) patients, there are few studies about brain structure changes in recent onset PTSD patients after a single extreme and prolonged trauma. In the current study, 20 coal mine flood disaster survivors underwent magnetic resonance imaging (MRI). Voxel-based morphometry (VBM) and region of interest (ROI) techniques were used to detect the gray matter and white matter volume changes in 10 survivors with recent onset PTSD and 10 survivors without PTSD. The correlation between the Clinician-Administered PTSD Scale (CAPS) and gray matter density in the ROI was also studied. Compared with survivors without PTSD, survivors with PTSD had significantly decreased gray matter volume and density in left anterior hippocampus, left parahippocampal gyrus, and bilateral calcarine cortex. The CAPS score correlated negatively with the gray matter density in bilateral calcarine cortex and left hippocampus in coal mine disaster survivors. Our study suggests that the gray matter volume and density of limbic structure decreased in recent onset PTSD patients who were exposed to extreme trauma. PTSD symptom severity was associated with gray matter density in calcarine cortex and hippocampus.
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Affiliation(s)
- Jian Zhang
- Department of Respiratory Medicine, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi, 710032, China
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Kira IA, Templin T, Lewandowski L, Ramaswamy V, Ozkan B, Abou-Mediane S, Mohanesh J, Alamia H. Cumulative Tertiary Appraisals of Traumatic Events Across Cultures: Two Studies. JOURNAL OF LOSS & TRAUMA 2011. [DOI: 10.1080/15325024.2010.519288] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Machado CL, de Azevedo RC, Facuri CO, Vieira MJN, Fernandes AMS. Posttraumatic stress disorder, depression, and hopelessness in women who are victims of sexual violence. Int J Gynaecol Obstet 2011; 113:58-62. [DOI: 10.1016/j.ijgo.2010.10.016] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2010] [Revised: 10/20/2010] [Accepted: 12/15/2010] [Indexed: 10/18/2022]
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Khoury L, Tang YL, Bradley B, Cubells JF, Ressler KJ. Substance use, childhood traumatic experience, and Posttraumatic Stress Disorder in an urban civilian population. Depress Anxiety 2010; 27:1077-86. [PMID: 21049532 PMCID: PMC3051362 DOI: 10.1002/da.20751] [Citation(s) in RCA: 267] [Impact Index Per Article: 19.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE Exposure to traumatic experiences, especially those occurring in childhood, has been linked to substance use disorders (SUDs), including abuse and dependence. SUDs are also highly comorbid with Posttraumatic Stress Disorder (PTSD) and other mood-related psychopathology. Most studies examining the relationship between PTSD and SUDs have examined veteran populations or patients in substance treatment programs. The present study further examines this relationship between childhood trauma, substance use, and PTSD in a sample of urban primary care patients. METHOD There were 587 participants included in this study, all recruited from medical and OB/GYN clinic waiting rooms at Grady Memorial Hospital in Atlanta, GA. Data were collected through both screening interviews as well as follow-up interviews. RESULTS In this highly traumatized population, high rates of lifetime dependence on various substances were found (39% alcohol, 34.1% cocaine, 6.2% heroin/opiates, and 44.8% marijuana). The level of substance use, particularly cocaine, strongly correlated with levels of childhood physical, sexual, and emotional abuse as well as current PTSD symptoms. In particular, there was a significant additive effect of number of types of childhood trauma experienced with history of cocaine dependence in predicting current PTSD symptoms, and this effect was independent of exposure to adult trauma. CONCLUSIONS These data show strong links between childhood traumatization and SUDs, and their joint associations with PTSD outcome. They suggest that enhanced awareness of PTSD and substance abuse comorbidity in high-risk, impoverished populations is critical to understanding the mechanisms of substance addiction as well as in improving prevention and treatment.
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Affiliation(s)
- Lamya Khoury
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, Georgia
| | - Yilang L Tang
- Department of Human Genetics, Emory University School of Medicine, Atlanta, Georgia
| | - Bekh Bradley
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, Georgia,Atlanta VA Medical Center, Decatur, Georgia
| | - Joe F Cubells
- Department of Human Genetics, Emory University School of Medicine, Atlanta, Georgia
| | - Kerry J Ressler
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, Georgia,Howard Hughes Medical Institute, Chevy Chase, Maryland,Yerkes National Primate Research Center, Atlanta, Georgia,*Correspondence to: Kerry J. Ressler, Howard Hughes Medical Institute, Department of Psychiatry and Behavioral Sciences, Yerkes Research Center, Emory University, 954 Gatewood Dr, Atlanta, GA 30329 E-mail:
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