Kunst, Maarten J. J.
The current study was developed to explore the associations between posttraumatic stress disorder (PTSD), level of compensation for pain and suffering, and employment status in a sample of victims of violence (n = 226) who had held a full-time job at time of victimization and had filed a claim with the Dutch Victim Compensation Fund (DVCF)…
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Kunst, Maarten; Winkel, Frans Willem; Bogaerts, Stefan
Many studies have focused on the predictive value of victims' emotions experienced shortly after violence exposure to identify those vulnerable for development of posttraumatic stress disorder (PTSD). However, many victims remain unidentified during the initial recovery phase, yet may still be highly in need of psychological help after substantial…
Nada-Raja, Shyamala; Skegg, Keren
This longitudinal population-based study examined pathways to nonsuicidal self-harm (NSSH) in relation to childhood sexual abuse (CSA), assault victimization in early adulthood, posttraumatic stress disorder symptomatology (PTSD), and other mental disorders. At age 21, 476 men and 455 women completed interviews on assault victimization, PTSD, and…
Kirchner, Teresa; Forns, Maria; Soler, Laia; Planellas, Irina
The cumulative effect of lifetime interpersonal victimization experiences (e.g., child maltreatment, sexual victimizations, conventional crime, witnessing indirect victimization, peer and sibling victimizations) on posttraumatic stress (PTS) symptoms is an important topic in the scientific literature. The objectives of the present study were: (a) to analyze the relationship between lifetime interpersonal victimizations and PTS symptoms, (b) to determine the most prevalent specific PTS symptoms among poly-victimized adolescents, and (c) to establish the time-based effect of interpersonal victimization experiences that occurred in the last year versus those that occurred years before on current level of PTS symptoms. Gender differences were taken into account for each of these objectives. Participants were 823 Spanish adolescents (63% girls and 37% boys) between 14 and 18 years of age recruited from May 2010 to November 2011 from schools in Barcelona, Spain. The majority (87.6%) was of Spanish nationality. The results highlighted the cumulative effect of interpersonal victimizations on PTS symptoms. Among poly-victims adolescents, the most prevalent PTS symptom was intrusive thoughts, but some differences were observed according to gender. The time-based effect of interpersonal victimizations showed a different pattern for girls and boys. For girls, the victimizing events occurring in past years had more explanatory power of the current PTS symptoms than those that occurred more recently. In boys, the interpersonal victimizing events occurring in the last year had the greater explanatory power. These results may have clinical and therapeutic value. Copyright © 2014 Elsevier Ltd. All rights reserved.
Shin, Kyoung Min; Chung, Young Ki; Shin, Yee Jin; Kim, Miran; Kim, Nam Hee; Kim, Kyoung Ah; Lee, Hanbyul; Chang, Hyoung Yoon
More than half of all sexual assault victims report experiencing sexual victimization more than once. The aim of this paper was to determine the role post-traumatic cognition plays in the relationship between a history of sexual abuse and post-traumatic stress symptoms in sexual assault victims. The relationship between a history of sexual assault and the severity of post-traumatic stress symptoms was investigated retrospectively using data from a sexual assault crisis center in Korea. Data on psychological symptoms were collected in person at the initial assessment and by telephone 1 month later using the Post-traumatic Cognitions Inventory and the Post-traumatic Stress Disorder Symptoms Scale: Self-report Version. Of 105 women included in the analysis, 10 (9.5%) reported prior sexual abuse and were classified as sexually revictimized. Revictimized women had more post-traumatic negative cognition at initial assessment (t = -2.98; P = 0.004) and more post-traumatic symptoms at 1 month follow-up (t = -2.39; P = 0.019) than singly victimized women. At 1 month follow-up, the severity of post-traumatic stress symptoms had increased in revictimized women but had decreased slightly in singly victimized women. Negative post-traumatic cognition fully mediated the association between a history of sexual abuse and the severity of post-traumatic stress symptoms. Early detection of sexually revictimized women and tailored service and treatment intervention is needed to better serve this group of victims. Interventions targeted at preventing revictimization or post crime victimization may also help victims recover from the trauma and prevent future abuse. © 2017 The Korean Academy of Medical Sciences.
Full Text Available Giuseppe Craparo,1 Alessio Gori,2 Elvira Mazzola,1 Irene Petruccelli,1 Monica Pellerone,1 Giuseppe Rotondo3 1Faculty of Human and Social Sciences, Kore University of Enna, Enna, Italy; 2Department of Psychology, University of Florence, Florence, Italy; 3Department of Psychology, Unit of Psychotraumatology, San Raffaele Giglio Hospital of Cefalù, Cefalù, Italy Background: Several studies have demonstrated a significant association between dissociation and posttraumatic symptoms. A dissociative reaction during a traumatic event may seem to predict the later development of posttraumatic stress symptoms. Moreover, several researchers also observed an alexithymic condition in a variety of traumatized samples.Methods: A total of 287 flood victims (men =159, 55.4%; women =128, 44.6% with an age range of 17–21 years (mean =18.33; standard deviation =0.68 completed the following: Impact of Event Scale–Revised, Dissociative Experiences Scale II, Twenty-Item Toronto Alexithymia Scale, and Peritraumatic Dissociative Experiences Questionnaire.Results: We found significant correlations among all variables. Linear regression showed that peritraumatic dissociation plays a mediator role between alexithymia, dissociation, and posttraumatic stress symptoms.Conclusion: Our results seem to confirm the significant roles of both dissociation and alexithymia for the development of posttraumatic symptoms. Keywords: peritraumatic dissociation, posttraumatic symptoms, PTSD
Fleming, Kimberly N; Newton, Tamara L; Fernandez-Botran, Rafael; Miller, James J; Ellison Burns, Vicki
This study aimed to further understanding of intimate partner stalking victimization in post-abuse women, with particular attention to the definition of stalking (with or without fear and threat) most predictive of posttraumatic stress (PTS) symptoms. In community midlife women with histories of divorce (N = 192), a history of stalking victimization accompanied by fear and threat was positively correlated with PTS symptom severity, after accounting for other partner abuse. The presence, compared with absence, of fear-and-threat stalking history doubled the odds of symptomatic levels of hyperarousal. Greater physical assault and injury chronicity differentiated fear-and-threat stalked women from other stalked women. Stalking contributed to a fuller understanding of PTS symptoms in women, showing particular relevance for hyperarousal.
Sotskova, Alina; Woodin, Erica M
The first year of parenthood can be a stressful time, especially for high-risk couples. Symptoms of posttraumatic stress (PTS) have been associated with decreased intimacy, communication, and relationship adjustment, yet there is a lack of research on how PTS symptoms might affect couples in early parenthood. Furthermore, there is little evidence regarding the way in which PTS symptoms may affect couples above and beyond known risk factors such as intimate partner violence (IPV) and harmful alcohol use. The current study investigated how PTS symptoms were related to new parents' relationship satisfaction in the context of IPV and harmful drinking. Ninety-eight heterosexual couples filled out questionnaires 1 year after the birth of their first child. Hierarchical multiple regression analyses indicated that, for men, PTS symptoms predicted lower relationship satisfaction over and above IPV victimization and harmful drinking. However, for women, psychological IPV victimization was the only significant multivariate predictor. In addition, for men, PTS symptoms interacted with harmful drinking to predict poorer relationship satisfaction. The results suggest that women's relationship satisfaction is particularly linked to psychological IPV victimization during early parenthood, whereas men's relationship satisfaction is particularly associated with their own harmful drinking and PTS symptoms. Implications are discussed.
Scarpa, Angela; Haden, Sara Chiara; Hurley, Jimmy
This study tested the relationship of community violence (CV) victimization to severity of posttraumatic stress disorder (PTSD), and the roles of coping style and perceived social support in moderating that relationship. Three-hundred seventy-two men and women (age 18 to 22 years) self-reported on CV exposure, traumatic experiences, PTSD symptoms,…
Full Text Available An increasing number of organizations face the problem of mobbing, which represents a serious, widespread problem with numerous consequences for victims, organizations, and society. We also recognize the connection this phenomenon has with the emergence of post-traumatic stress disorder (PTSD. PTSD poses one of the most critical consequences for victims of mobbing, who mostly consist of employees at lower organizational levels. Our research focuses on the prevalence of mobbing in Slovenia, its correlation to PTSD, and some differences in the subjective and objective assessments of being exposed to mobbing. We found that the prevalence of mobbing in Slovenia can be compared to some previous assessments as well as data from other countries. Among the study's participants, 24% could be classified as regular victims of mobbing. For the first time, we link mobbing with PTSD using a Slovenian sample. We also recorded some interesting differences between subjective and objective assessments of mobbing, thereby indicating the importance of subjective conceptualizations of mobbing acts, which should be investigated in greater detail in future research.
Roberts, Andrea L; Koenen, Karestan C; Lyall, Kristen; Robinson, Elise B; Weisskopf, Marc G
Persons with autistic traits may be at elevated risk for interpersonal victimization across the life course. Children with high levels of autistic traits may be targeted for abuse, and deficits in social awareness may increase risk of interpersonal victimization. Additionally, persons with autistic traits may be at elevated risk of posttraumatic stress disorder (PTSD) symptoms subsequent to trauma. We examined retrospectively reported prevalence of childhood abuse, trauma victimization and PTSD symptoms by autistic traits among adult women in a population-based longitudinal cohort, the Nurses' Health Study II (N=1,077). Autistic traits were measured by the 65-item Social Responsiveness Scale. We estimated odds ratios (OR) for childhood sexual and physical/emotional abuse and PTSD symptoms by quintiles of autistic traits. We examined possible mediation of PTSD risk by abuse and trauma type. Women in the highest versus lowest quintile of autistic traits were more likely to have been sexually abused (40.1% versus 26.7%), physically/emotionally abused (23.9% versus 14.3%), mugged (17.1% versus 10.1%), pressured into sexual contact (25.4% versus 15.6%) and have high PTSD symptoms (10.7% versus 4.5%). Odds of PTSD were elevated in women in the top three quintiles of autistic traits compared with the reference group (OR range=1.4 to 1.9). Childhood abuse exposure partly accounted for elevated risk of PTSD in women with autistic traits. We identify for the first time an association between autistic traits, childhood abuse, trauma victimization, and PTSD. Levels of autistic traits that are highly prevalent in the general population are associated with abuse, trauma and PTSD. Copyright © 2015 Elsevier Ltd. All rights reserved.
There are no known studies to date examining the risk of posttraumatic stress disorder (PTSD) associated with sudden and dramatic personal financial loss. A Web-based, online, nonprobability convenience survey of 172 Madoff victims (56 percent female; mean age, 60.9 years) using the Posttraumatic Stress List Checklist, civilian version was…
Weaver, Terri L.; Griffin, Michael G.; Mitchell, Elisha R.
While body image concerns and interpersonal violence exposure are significant issues for women, their interrelationship has been rarely explored. We examined the associations between severity of acute injuries, symptoms of posttraumatic stress disorder (PTSD), depression and body image distress within a sample of predominantly African-American victims of interpersonal violence (N = 73). Severity of body image distress was significantly associated with each outcome. Moreover, body image distre...
Full Text Available BackgroundHuman trafficking is a form of modern slavery that involves the forced movement of people internally within countries, or externally across borders. Victims who are trafficked for sexual exploitation are subject to repeated, multiple trauma, and high rates of mental health problems including posttraumatic stress disorder (PTSD have been found. Narrative exposure therapy (NET is an evidence-based treatment for PTSD.MethodsIn this retrospective audit, we record the results of NET to treat 10 women who had been trafficked for sexual exploitation who were diagnosed with PTSD.ResultsAll 10 women completed the therapy and experienced a reduction in PTSD severity scores at posttreatment, with improvements that were maintained or further improved at 3-month follow-up. General distress was also significantly reduced following treatment.ConclusionAlthough limited by sample size and retrospective design, this audit demonstrates that NET is a feasible treatment for PTSD in this population and warrants further evaluation in a randomized controlled trial. Further adjunctive interventions may also be necessary to treat the additional psychological problems experienced by this population.
Aydin, Berna; Akbas, Seher; Turla, Ahmet; Dundar, Cihad
Background Social support has been shown to play a protective role against the development of post-traumatic stress disorder (PTSD) and depression in individuals exposed to trauma. Aims The purpose of this study was to investigate the effect of perceived social support on depression and PTSD in child victims of sexual abuse and to determine the relationship between them. Method In total 182 victims of sexual abuse aged 6-18 at time of interview were assessed. Clinical interviews, the Children's Depression Inventory (CDI) and the Child Posttraumatic Stress Reaction Index (CPTS-RI) were used to assess children's psychological status, while the Perceived Social Support Scale-Revised (PSSS-R) was used to measure social support. Results Girls had significantly higher median CDI and CPTS-RI scores than boys, while no significant difference was determined between boys and girls in terms of PSSS-R scores. A statistically significant negative correlation was determined between CDI and PSSS-R scores, CPTS-RI scores and PSSS-R scores in girls, while no significant correlation was identified in male victims. Conclusions In conclusion, we think that social support networks for victims of sexual abuse need to be broadened and increased, and that importance should be attached to protective approaches in that context.
Hetzel, Melanie D.; McCanne, Thomas R.
Objective: Previous research has indicated that women who experience childhood physical abuse or childhood sexual abuse are at increased risk for posttraumatic stress disorder (PTSD) and adult victimization. Recently, peritraumatic dissociation (PD) has been suggested as another possible risk factor for PTSD and adult victimization. The purpose of…
Shin, Kyoung Min; Chang, Hyoung Yoon; Cho, Sun-Mi; Kim, Nam Hee; Kim, Kyoung Ah; Chung, Young Ki
Victimization by sexual violence is strongly associated with the development of posttraumatic stress disorder (PTSD). While several psychological and cognitive factors are known to be associated with PTSD prognosis, multivariable analysis is scarce. This study examined factors affecting the severity of PTSD symptoms in early stage of traumatic experience of sexual violence, including initial post-traumatic symptoms and cognitive characteristics. Participants were recruited from the center for women and children victims of violence in a university hospital. Thirty-four sexual assault victims were assessed at the baseline and the second visit one to five months after the baseline. At the baseline, an array of posttraumatic symptoms and cognitive functions were measured: at follow-up, PTSD symptoms were determined by Clinician Administered PTSD Scale. Stepwise multiple regression showed that avoidance symptoms (β = 0.551, P symptoms one to five month later. The regression model, factoring in avoidance and delayed verbal memory, showed a 34.9% explanatory power regarding the PTSD symptom severity. This study suggests that avoidance symptoms and verbal memory at the early stage of trauma are associated with later PTSD symptoms. It is also suggested that early intervention targeting avoidance symptoms may be beneficial in decreasing PTSD symptoms. Copyright © 2015 Elsevier B.V. All rights reserved.
Rivera-Vélez, Giselle M; González-Viruet, Maribella; Martínez-Taboas, Alfonso; Pérez-Mojica, Deborah
This study compared the memory, attention/concentration, and executive functioning of 12 women with histories of child sexual abuse with a control group of 12 women without childhood abuse. Participants completed a neuropsychological test battery and various instruments assessing post-traumatic stress disorder and dissociation. The child sexual abuse group had lower performance than the control group on long- and short-term visual and verbal memory and presented more limited performance on executive functioning tasks. Functioning in these areas showed a negative correlation with post-traumatic stress disorder and dissociative symptoms. These findings suggest that child sexual abuse is associated with memory and executive functioning deficits and supports the idea that people with trauma histories and increased post-traumatic stress disorder and dissociation symptoms may have alterations in neuropsychological functioning.
Nielsen, Morten Birkeland; Birkeland, Marianne Skogbrott; Hansen, Marianne Bang; Knardahl, Stein; Heir, Trond
This study examined relationships between victimization from bullying and symptoms of posttraumatic stress (PTSS) after exposure to a terror attack at the workplace. It was hypothesized that (1) victims of bullying report higher and more stable levels of PTSS over time compared to their non-bullied colleagues and (2) that PTSS provides an increased risk of subsequent victimization from bullying. The hypotheses were tested in a two-wave prospective sample comprising 2337 employees from Norwegian governmental ministries who were exposed to the 2011 Oslo terror attack. The two waves of data collection were conducted 10 and 22 months after the terror attack. Hypothesis 1 was partially supported: victims of bullying reported significantly higher levels of PTSS than non-bullied employees at both measurement points, but bullying was not related to the stability in PTSS over time. In support of hypothesis 2, PTSS at 10 months was significantly associated with an increased risk of feeling victimized by bullying 1 year later. The results indicate that victimization from bullying is associated with elevated levels of PTSS in the aftermath of a workplace terror attack, but that bullying does not have any impact on the long-term development of PTSS. PTSS may be a potential antecedent of bullying. These findings suggest that organizations must give high priority to the psychosocial work environment of traumatized employees to prevent further detrimental health consequences.
Fleurkens, P.F.T.; Rinck, M.; Minnen, A. van
Background: Avoidance of stimuli that are associated with the traumatic event is a key feature of posttraumatic stress disorder (PTSD). Thus far, studies on the role of avoidance in the development and maintenance of PTSD focused primarily on strategic or explicit avoidance. However, patients may
Fleurkens, P.F.T.; Rinck, M.; Minnen, A. van
The present study investigated specificity of attentional biases for trauma-related stimuli using an Emotional Stroop Task. Participants were 14 women suffering from posttraumatic stress disorder (PTSD) who had experienced a sexual trauma and 24 healthy non-traumatized women. They were asked to name
Timmons-Mitchell, Jane; Chandler-Holtz, Dawn; Semple, William E.
Explores the relationship among children's (n=24) allegations of sexual abuse, children's post-traumatic stress disorder (PTSD) symptoms, mothers' sexual-abuse history, and mothers' PTSD symptoms. The presence of PTSD symptoms were equal between children whose mothers reported being sexually abused as a child and those whose mothers did not report…
Weaver, Terri L; Griffin, Michael G; Mitchell, Elisha R
While body image concerns and interpersonal violence exposure are significant issues for women, their interrelationship has rarely been explored. We examined the associations between severity of acute injuries, symptoms of posttraumatic stress disorder (PTSD), depression, and body image distress within a sample of predominantly African American victims of interpersonal violence (N = 73). Severity of body image distress was significantly associated with each outcome. Moreover, body image distress was a significant, unique predictor of depression but not PTSD severity. We recommend continued exploration of body image concerns to further integrated research on violence against women.
Maercker, Andreas; Mohiyeddini, Changiz; Müller, Mario; Xie, Wei; Hui Yang, Zhi; Wang, Jiangping; Müller, Julia
The influence of cultural factors on mental health is not disputed in general - but elaborated research approaches are still lacking. We investigate cultural influences not only by nationality but also by value orientation (modern vs. traditional). A cross-cultural comparison with Chinese and German crime victims included an assessment of value orientation according to Schwartz's theory (Schwartz, 1994) of personal values. Chinese and German adult crime victims were assessed. By means of structural equation multi-sample analysis, data of the two groups were compared. Traditional (conformity, benevolence, customs orientation) and modern values (achievement, hedonism, stimulation), traumatic exposure, posttraumatic stress (PTS), and two self-perceived interpersonal mediator processes (disclosure intentions, social acknowledgement as a victim) were assessed by self-report measures in 130 Chinese and 151 German crime victims. The two patterns of prediction for PTS differed between the countries: In the German sample both value types but in the Chinese sample only traditional values were directly or indirectly predictive of PTS. Traditional values inhibited social acknowledgement as a victim in China and Germany. In Germany, traditional values were related to increased PTS severity. Modern values predicted social acknowledgement as well as lower symptoms in Germany, but not in China. The study shows cultural and interpersonal factors that may contribute to the development of PTSD that are under-researched in contemporary psychology and psychotherapy.
Zinzow, Heidi M; Rheingold, Alyssa A; Byczkiewicz, Michelle; Saunders, Benjamin E; Kilpatrick, Dean G
The present study examined posttraumatic stress disorder (PTSD) symptoms among friends and family members of homicide victims (homicide survivors). Out of a national sample of 1,753 young adults who completed follow-up interviews after participating in the National Survey of Adolescents, 268 homicide survivors and 653 victims of other interpersonal violence were selected for the study. Participants completed structured telephone interviews that covered the loss of a family member or close friend to homicide, violence exposure, and PTSD symptomatology. Findings indicated that 39% of homicide survivors met criteria for all 3 symptom clusters and 30% of homicide survivors met criteria for 2 PTSD clusters (functional impairment was not assessed). Multivariate logistic regression analyses demonstrated that homicide survivors were more likely than victims of other violence to meet criteria for all 3 PTSD symptom clusters (OR = 1.91, p homicide survivors. Results suggest that homicide survivors are at elevated risk for PTSD symptoms in comparison to victims of other interpersonal violence. Copyright © 2011 International Society for Traumatic Stress Studies.
Bressan Rodrigo A
Full Text Available Abstract Background Life trauma is highly prevalent in the general population and posttraumatic stress disorder is among the most prevalent psychiatric consequences of trauma exposure. Brazil has a unique environment to conduct translational research about psychological trauma and posttraumatic stress disorder, since urban violence became a Brazilian phenomenon, being particularly related to the rapid population growth of its cities. This research involves three case-control studies: a neuropsychological, a structural neuroimaging and a molecular neuroimaging study, each focusing on different objectives but providing complementary information. First, it aims to examine cognitive functioning of PTSD subjects and its relationships with symptomatology. The second objective is to evaluate neurostructural integrity of orbitofrontal cortex and hippocampus in PTSD subjects. The third aim is to evaluate if patients with PTSD have decreased dopamine transporter density in the basal ganglia as compared to resilient controls subjects. This paper shows the research rationale and design for these three case-control studies. Methods and design Cases and controls will be identified through an epidemiologic survey conducted in the city of São Paulo. Subjects exposed to traumatic life experiences resulting in posttraumatic stress disorder (cases will be compared to resilient victims of traumatic life experiences without PTSD (controls aiming to identify biological variables that might protect or predispose to PTSD. In the neuropsychological case-control study, 100 patients with PTSD, will be compared with 100 victims of trauma without posttraumatic stress disorder, age- and sex-matched controls. Similarly, 50 cases and 50 controls will be enrolled for the structural study and 25 cases and 25 controls in the functional neuroimaging study. All individuals from the three studies will complete psychometrics and a structured clinical interview (the Structured
Bosmans, Mark; van der Knaap, Leontien; van der Velden, Peter
Objective: To assess and compare the (independent) predictive value of trauma-related coping selfefficacy (CSE) for posttraumatic stress symptoms (PTSS) among a treatment sample and a comparison group of nontreatment seeking victims. Method: Both the treatment (N 54) and comparison group (N 144)
Maikovich, Andrea Kohn; Koenen, Karestan C.; Jaffee, Sara R.
Very few studies have prospectively examined sex differences in posttraumatic stress symptoms and symptom trajectories in youth victimized by childhood sexual abuse. This study addresses that question in a relatively large sample of children, drawn from the National Survey of Child and Adolescent Well-Being, who were between the ages of 8-16 years…
Soberón, Carmen; Crespo, María; Del Mar Gómez-Gutiérrez, María; Fernández-Lansac, Violeta; Armour, Cherie
Confirmatory factor analytic studies have shown that posttraumatic stress disorder (PTSD) symptoms included in the fifth edition of the Diagnostic and Statistical Manual Disorders (DSM-5) may be better explained by two 6-factor models (the Externalizing Behaviours model and the Anhedonia model) and a 7-factor Hybrid model. The latter model comprises the symptom clusters of intrusion, avoidance, negative affect, anhedonia, externalizing behaviours, and anxious and dysphoric arousal. This model has received empirical support mainly in American samples. Of note, there have been a limited number of studies conducted on samples from other countries. This study aimed to examine the underlying dimensionality of DSM-5 PTSD symptoms in a Spanish clinical sample exposed to a range of traumatic events. Participants included 165 adults (78.8% females) seeking treatment in trauma services in the Madrid area (Spain). PTSD was assessed using the Global Assessment of Posttraumatic Stress Scale 5, a Spanish self-report instrument assessing posttraumatic symptoms according to the DSM-5 criteria. Confirmatory factor analyses were conducted in Mplus. Both the 7-factor Hybrid model and the 6-factor Anhedonia model demonstrated good and equivalent fit to the data. The findings of this study replicate and extend previous research by providing support for both the 7-factor Hybrid model and the 6-factor Anhedonia model in a clinical sample of Spanish trauma survivors. Given equivalent fit for these two models and the fewer number of latent factors in the Anhedonia model, it was selected as optimal in a traumatized Spanish sample. Implications and future research directions are discussed.
Brewin, C R; Andrews, B; Rose, S
A DSM-IV diagnosis of posttraumatic stress disorder (PTSD) required for the first time that individuals must report experiencing intense fear, helplessness, or horror at the time of the trauma. In a longitudinal study of 138 victims of violent crime, we investigated whether reports of intense trauma-related emotions characterized individuals who, after 6 months, met criteria for PTSD according to the DSM-III-R. We found that intense levels of all 3 emotions strongly predicted later PTSD. However, a small number of those who later met DSM-III-R or ICD criteria for PTSD did not report intense emotions at the time of the trauma. They did, however, report high levels of either anger with others or shame.
Fleurkens, Pascal; Rinck, Mike; van Minnen, Agnes
The present study investigated specificity of attentional biases for trauma-related stimuli using an Emotional Stroop Task. Participants were 14 women suffering from posttraumatic stress disorder (PTSD) who had experienced a sexual trauma and 24 healthy non-traumatized women. They were asked to name print colors of 4 different word types: threatening sexual violence words and non-threatening sexual words, threatening accident trauma words, and positive words. Compared to control participants, PTSD patients displayed increased interference by threatening trauma-related, but not by accident trauma and positive words. Interference by non-threatening sexual words occurred as well, but only in those patients who suffered from more severe PTSD arousal symptoms. These findings suggest graded generalization of the attentional bias across stimuli of varying emotional valence, but specificity regarding the trauma topic. Results are discussed in light of current cognitive models of PTSD, and clinical implications are suggested. Copyright © 2011 Elsevier Ltd. All rights reserved.
Full Text Available Background: Compelling evidence has shown that motor vehicle accidents have an enormous impact on mental health. Post-traumatic Stress Disorder (PTSD is one of the most common psychological consequences in adult survivors of accidents, so it is important to understand the prevalence and predictors of this issue since delay causes damage to crucial daily functioning. This study aimed at investigating the prevalence and predictors of PTSD after motor vehicle accident. Methods: This cross-sectional study was conducted on 528 injured patients six weeks to six months after motor vehicle accident in Imam Reza Clinic of Poursina hospital, Rasht in 2015. Data collection tools were three questionnaires including post-traumatic stress-self report (PSS, Beck Depression Inventory (BDI-II, and the Numeric Rating Scale (NRS for pain. The data were analyzed in SPSS (Version 19 using Chi-square, Fischer’s exact test and multivariate logistic regression. Significance level was considered P≤0.05. Results: The prevalence of PTSD and depression was 30.49% and 19.89% in participants, respectively. Chi-square test indicated a significant relationship among age (P=0.02, sex (P<0.001, education level (P<0.001, work status (P<0.001 and PTSD. Participants who reported pain (P<0.001 and depression (P<0.001 were more likely to have high score of PTSD than the others. Multivariate logistic regression showed this significance in sex, depression, age, educational status and pain, as constant risk factors in developing PTSD after accident. Conclusion: This study suggests that primary care setting should be readily prompted for diagnosis of these disorders in non-treatment seeking individuals in the community.
Rinear, Eileen E.
This paper recognizes murder as a major cause of mortality among adolescents and young adults and addresses the need for research examining the effects of murder on the victim's surviving family members. The information contained in this report was obtained from surveys completed by 237 members of the Parents of Murdered Children support group.…
Karsberg, Sidsel; Armour, Cherie; Elklit, Ask
The current study had two main aims. The first was to identify groups of adolescents based on their similarity of responding across a number of victimizing and potentially traumatic events (PTEs). In doing so, we employed the statistical technique of Latent Class Analysis (LCA). The second aim was to assess the relationship between our resultant classes and the covariates of gender, suicide attempt, and PTSD. Two hundred and sixty-nine Greenlandic school students, aged 12-18 (M = 15.4, SD = 1.84) were assessed for their level of exposure to PTEs. In addition, adolescents were assessed for the psychological impact of these events. A LCA was performed on seven binary indicators representing PTEs. Logistic regression was subsequently implemented to ascertain the relationships between latent classes and covariates. Three distinct classes were uncovered: a violence, neglect, and bullying class (class 1), a wide-ranging multiple PTE class (class 2), and a normative/baseline class (class 3). Notably, classes 1 and 2 were largely separated by the presence or absence of sexual PTEs. Individuals who reported having previously attempted suicide were almost six times more likely to be members of class 1 (OR = 5.97) and almost four times more likely to be members of class 2 (OR = 3.87) compared to the baseline class (class 3). Individuals who met the diagnostic criteria for PTSD were five times as likely to be members of class 1 and class 2 (OR = 5.09) compared to the baseline class. No significant associations were found between classes and gender. The results underline the complexity of the interplay between multiple victimization experiences, traumatization, and suicide attempts.
Green, Tamar; Kotler, Moshe
The characteristic symptoms resulting from exposure to an extreme trauma include three clusters of symptoms: persistent experience of the traumatic event, persistent avoidance of stimuli associated with the trauma and persistent symptoms of increased arousal. Beyond the accepted clusters of symptoms for posttraumatic stress disorder exists a formation of symptoms related to exposure to extreme or prolonged stress e.g. childhood abuse, physical violence, rape, and confinement within a concentration camp. With accumulated evidence of the existence of these symptoms began a trail to classify a more complex syndrome, which included, but was not confined to the symptoms of posttraumatic stress disorder. This review addresses several subjects for study in complex posttraumatic stress disorder, which is a complicated and controversial topic. Firstly, the concept of complex posttraumatic stress disorder is presented. Secondly, the professional literature relevant to this disturbance is reviewed and finally, the authors present the polemic being conducted between the researchers of posttraumatic disturbances regarding validity, reliability and the need for separate diagnosis for these symptoms.
Johansen, Venke A; Wahl, Astrid K; Eilertsen, Dag Erik; Weisaeth, Lars; Hanestad, Berit R
Background Little is known about longitudinal associations between post-traumatic stress disorder (PTSD) and quality of life (QoL) after exposure to violence. The aims of the current study were to examine quality of life (QoL) and the predictive value of post-traumatic stress disorder (PTSD) for QoL in victims of non-domestic violence over a period of 12 months. Methods A single-group (n = 70) longitudinal design with three repeated measures over a period of 12 months were used. Posttraumatic psychological symptoms were assessed by using the Impact of Event Scale, a 15-item self-rating questionnaire comprising two subscales (intrusion and avoidance) as a screening instrument for PTSD. The questionnaire WHOQOL-Bref was used to assess QoL. The WHOQOL-BREF instrument comprises 26 items, which measure the following broad domains: physical health, psychological health, social relationships, and environment. Results of the analysis were summarized by fitting Structural Equation Modelling (SEM). Results For each category of PTSD (probable cases, risk level cases and no cases), the mean levels of the WHOQOL-Bref subscales (the four domains and the two single items) were stable across time of assessment. Individuals who scored as probable PTSD or as risk level cases had significantly lower scores on the QoL domains such as physical health, psychological health, social relationships and environmental than those without PTSD symptoms. In addition, the two items examining perception of overall quality of life and perception of overall health in WHOQOL showed the same results according to PTSD symptoms such as QoL domains. PTSD symptoms predicted lower QoL at all three assessments. Similarly PTSD symptoms at T1 predicted lower QoL at T2 and PTSD symptoms at T2 predicted lower QoL at T3. Conclusion The presence of PTSD symptoms predicted lower QoL, both from an acute and prolonged perspective, in victims of non-domestic violence. Focusing on the individual's perception of his
Kunst, M. J. J.; Winkel, F. W.; Bogaerts, S.
A mixed cross-sectional and longitudinal design was employed to explore the association between posttraumatic anger and posttraumatic stress disorder (PTSD; symptoms) in victims of civilian violence. It was speculated that this relationship is mainly due to concurrent recalled peritraumatic emotions. Such emotions may be interpreted to result from…
Teche, Stefania Pigatto; Barros, Alcina Juliana Soares; Rosa, Regis Goulart; Guimarães, Luciano Pinto; Cordini, Kariny Larissa; Goi, Julia Domingues; Hauck, Simone; Freitas, Lucia Helena
This study investigated the association between resilience and posttraumatic stress disorder (PTSD) among Brazilian victims of urban violence. It also compared defense mechanisms, parental bonding, and childhood trauma between those who developed PTSD and those who did not. This cross-sectional case-control study included 66 adult subjects exposed to recent urban violence in southern Brazil - 33 with PTSD and 33 healthy controls matched by sex and age - who were administered the Resilience Scale, Defense Style Questionnaire, Parental Bonding Instrument, and Childhood Trauma Questionnaire. The statistical tests used were the McNemar test for categorical variables, the Wilcoxon signed-rank test for continuous asymmetric variables, and the paired Student t-test for continuous symmetric variables. The PTSD group showed lower total Resilience Scale scores compared with controls (128.4±20.7 vs. 145.8±13.1, respectively; p = 0.01), along with a lower ability to solve situations and lower personal values that give meaning to life (p = 0.019). They also had lower rates of mature defense mechanisms (p resilience, especially the ability to solve situations and having personal values that give meaning to life, immature defense mechanisms, and emotional and physical abuse in childhood are associated with PTSD in adult Brazilian victims of urban violence.
Shin, Kyoung Min; Chang, Hyoung Yoon; Cho, Sun-Mi; Kim, Nam Hee; Kim, Kyoung Ah; Chung, Young Ki
.... This study examined factors affecting the severity of PTSD symptoms in early stage of traumatic experience of sexual violence, including initial post-traumatic symptoms and cognitive characteristics...
Verger, Pierre; Dab, William; Lamping, Donna L; Loze, Jean-Yves; Deschaseaux-Voinet, Céline; Abenhaim, Lucien; Rouillon, Frédéric
A wave of bombings struck France in 1995 and 1996, killing 12 people and injuring more than 200. The authors conducted follow-up evaluations with the victims in 1998 to determine the prevalence of and factors associated with posttraumatic stress disorder (PTSD). Victims directly exposed to the bombings (N=228) were recruited into a retrospective, cross-sectional study. Computer-assisted telephone interviews were conducted to evaluate PTSD, per DSM-IV criteria, and to assess health status before the attack, initial injury severity and perceived threat at the time of attack, and psychological symptoms, cosmetic impairment, hearing problems, and health service use at the time of the follow-up evaluation. Factors associated with PTSD were investigated with univariate logistic regression followed by multiple logistic regression analyses. A total of 196 respondents (86%) participated in the study. Of these, 19% had severe initial physical injuries (hospitalization exceeding 1 week). Problems reported at the follow-up evaluation included attack-related hearing problems (51%), cosmetic impairment (33%), and PTSD (31%) (95% confidence interval=24.5%-37.5%). Results of logistic regression analyses indicated that the risk of PTSD was significantly higher among women (odds ratio=2.54), participants age 35-54 (odds ratio=2.83), and those who had severe initial injuries (odds ratio=2.79) or cosmetic impairment (odds ratio=2.74) or who perceived substantial threat during the attack (odds ratio=3.99). The high prevalence of PTSD 2.6 years on average after a terrorist attack emphasizes the need for improved health services to address the intermediate and long-term consequences of terrorism.
Fraguas, D; Terán, S; Conejo-Galindo, J; Medina, O; Sainz Cortón, E; Ferrando, L; Gabriel, R; Arango, C
To determine the change in prevalence of posttraumatic stress disorder (PTSD) symptoms in victims of the March 11 attacks and their relatives, 1 and 6 months after the attacks. Evaluation of PTSD symptoms using the Davidson Trauma Scale (DTS) and General Health Questionnaire (GHQ) in a sample of 56 patients admitted to an emergency room of a general hospital, and assessment of PTSD symptoms in relatives of the patients. At Month 1, 41.1% of patients (31.3% of males and 54.2% of females) presented with PTSD. At Month 6, this figure was 40.9% (30.4% of males and 52.4% of females). There was a significant improvement in perception of health among females between Month 1 and Month 6. Relatives presented similar DTS scores at baseline and at 6 months. We verified that rates of PTSD did not vary substantively between the two evaluations. PTSD symptoms positively correlated with psychological health involvement. This correlation points out that both PTSD symptoms and subjective general health involvement are part of the psychological response to trauma. The prevalence of PTSD symptoms was high and remained stable between Month 1 and Month 6, while subjective perception of health improved significantly.
Zwissler, B; Hauswald, A; Koessler, S; Ertl, V; Pfeiffer, A; Wöhrmann, C; Winkler, N; Kissler, J
Traumatized individuals and particularly post-traumatic stress disorder (PTSD) patients are characterized by memory disturbances that suggest altered memory control. The present study investigated the issue using an item method, directed forgetting (DF) paradigm in 51 civil war victims in Uganda. All participants had been exposed to severe traumatic stress and 26 additionally suffered from PTSD. In an item cued, DF paradigm photographs were presented, each followed by an instruction to either remember or forget it. A recognition test for all initially presented photographs and thematically similar distracters followed. DF patterns were compared between the non-PTSD and the PTSD groups. Post-experimental ratings of picture valence and arousal were collected and correlated with DF. Results revealed DF, that is, reduced recognition for 'to-be-forgotten' items in the non-PTSD but not in the PTSD group. Moreover, in the non-PTSD, but not in the PTSD group, false alarms were reduced for 'to-be-remembered' items. Finally, DF was reduced in those participants who rated the pictures as more arousing, the PTSD group giving, on average, higher arousal ratings. Data indicate that DF is reduced in PTSD and that the reduction is related to stimulus arousal. Furthermore, individuals with PTSD are characterized by a more global encoding style than individuals without PTSD, reflected in a higher false alarm rate. In sum, traumatized individuals with (but not without) PTSD are impaired in their ability to selectively control episodic memory encoding. This impairment may contribute to clinical features of the disorder such as intrusions and flashbacks.
... 2017). VA/DoD clinical practice guideline for the management of posttraumatic stress disorder and acute stress disorder (Version 3.0). Washington, DC: Veterans Health Administration, Department of Defense. ...
Galor, Sharon; Hentschel, Uwe
The primary objective of this study was to identify the vulnerability factors for suicide attempts in an Israeli sample, with the help of the Gottschalk-Gleser content analysis scales. The respondents were divided into four groups: suicide attempters; controls; post-traumatic stress disorder and depressed patients who did not report suicidal…
Şimşek, Şeref; Yüksel, Tuğba; Kaplan, İbrahim; Uysal, Cem; Aktaş, Hüseyin
The aim of this study was to investigate whether cortisol and oxidative stress levels and DNA damage differ between individuals who developed PTSD or not following a sexual trauma. The study included 61 children aged between 5 and 17 years who sustained sexual abuse (M/F: 18/43). The patients were divided into two groups: patients with PTSD and patients without PTSD based, based on the results of a structured psychiatric interview (K-SADS-PL and CAPS-CA). Cortisol, glutathione peroxidase (GPx), superoxide dismutase (SOD), coenzyme Q, 8-Hydroxy-2-Deoxyguanosine (8-OHdG) were all evaluated by the ELISA method. Our evaluation revealed a diagnosis of PTSD in 51% (n=31) of victims. There was no significant difference between the groups with or without PTSD in terms of cortisol, GPx, SOD, coenzyme Q, and 8-OHdG levels. There was no correlation between CAPS scores and GPx, SOD, coenzyme Q, and 8-OHdG levels between patients with or without PTSD. In patients with PTSD, both cortisol and 8-OHdG levels decreased with increasing time after trauma, and there was no significant correlation with cortisol and 8-OHdG levels in patients without PTSD. Although the present study did not find any difference between the groups in terms of 8-OHdG concentrations, the decreases in both cortisol and 8-OHdG levels with increasing time after trauma is considered to indicate a relationship between cortisol and DNA damage.
Post-traumatic stress disorder (PTSD) Overview Post-traumatic stress disorder (PTSD) is a mental health condition that's triggered by a terrifying event — either experiencing it or witnessing it. Symptoms may include flashbacks, ...
Eylem Ozten; Gokben Hizli Sayar
Post-traumatic stress disorder is a very broad category among mental disorders. Since its inclusion in DSM-III, the diagnostic criteria of post-traumatic stress disorder has undergone a number of changes...
Feb 7, 2018 ... Depression and Posttraumatic Stress Disorder among Road Traffic. Accident Victims Managed in a Tertiary Hospital ... noted ill-health states (i.e., are healthy with respect to PTSD or MDD). The researchers ... School of Public Health, Tehran University of Medical Sciences,. 1Health Information Management ...
This study was carried out to find out the relationship between rape experience and of Post-traumatic Stress Disorder among victims. One hundred and thirty-two female participants made up of seventy-two from Nasarawa State University and sixty from the general public in Keffi town of Nasarawa State participated in the ...
Most individuals will experience a traumatic event during their lives and some will develop subsequent posttraumatic stress disorder (PTSD). PTSD is characterized by symptoms of re-experiencing the traumatic event, avoidance of reminders of the event, and hyperarousal symptoms. The thesis of Miriam
According to the Diagnostic and Statistical Manual of Mental Disorders, delayed posttraumatic stress disorder (PTSD) must be diagnosed in individuals fulfilling criteria for PTSD if the onset of symptoms is at least six months after the trauma. The purpose of this thesis was to establish the
... stress can lead to PTSD. It often develops after a direct experience in which someone is seriously injured or threatened with injury or death. It also can happen to people who witness stressful events or learn ...
Full Text Available Unexpected extreme sudden traumatic stressor may cause post-traumatic stress disorder (PTSD. Important traumatic events include war, violent personal assault (e.g., sexual assault, and physical attack, being taken hostage or kidnapped, confinement as a prisoner of war, torture, terrorist attack, severe car accidents, and natural disasters. In childhood age sexual abuse or witnessing serious injuries or unexpected death of a beloved one are among important traumatic events. PTSD can be categorized into two types of acute and chronic PTSD: if symptoms persist for less than three months, it is termed “acute PTSD,” otherwise, it is called “chronic PTSD.” 60.7% of men and 51.2% of women would experience at least one potentially traumatic event in their lifetime. The lifetime prevalence of PTSD is significantly higher in women than men. Lifetime prevalence of PTSD varies from 0.3% in China to 6.1% in New Zealand. The prevalence of PTSD in crime victims are between 19% and 75%; rates as high as 80% have been reported following rape. The prevalence of PTSD among direct victims of disasters was reported to be 30%–40%; the rate in rescue workers was 10%–20%. The prevalence of PTSD among police, fire, and emergency service workers ranged from 6%–32%. An overall prevalence rate of 4% for the general population, the rate in rescue/recovery occupations ranged from 5% to 32%, with the highest rate reported in search and rescue personnel (25%, firefighters (21%, and workers with no prior training for facing disaster. War is one of the most intense stressors known to man. Armed forces have a higher prevalence of depression, anxiety disorders, alcohol abuse and PTSD. High-risk children who have been abused or experienced natural disasters may have an even higher prevalence of PTSD than adults. Female gender, previous psychiatric problem, intensity and nature of exposure to the traumatic event, and lack of social support are known risk factors for
Javidi, H; Yadollahie, M
Unexpected extreme sudden traumatic stressor may cause post-traumatic stress disorder (PTSD). Important traumatic events include war, violent personal assault (e.g., sexual assault, and physical attack), being taken hostage or kidnapped, confinement as a prisoner of war, torture, terrorist attack, severe car accidents, and natural disasters. In childhood age sexual abuse or witnessing serious injuries or unexpected death of a beloved one are among important traumatic events.PTSD can be categorized into two types of acute and chronic PTSD: if symptoms persist for less than three months, it is termed "acute PTSD," otherwise, it is called "chronic PTSD." 60.7% of men and 51.2% of women would experience at least one potentially traumatic event in their lifetime. The lifetime prevalence of PTSD is significantly higher in women than men. Lifetime prevalence of PTSD varies from 0.3% in China to 6.1% in New Zealand. The prevalence of PTSD in crime victims are between 19% and 75%; rates as high as 80% have been reported following rape. The prevalence of PTSD among direct victims of disasters was reported to be 30%-40%; the rate in rescue workers was 10%-20%. The prevalence of PTSD among police, fire, and emergency service workers ranged from 6%-32%. An overall prevalence rate of 4% for the general population, the rate in rescue/recovery occupations ranged from 5% to 32%, with the highest rate reported in search and rescue personnel (25%), firefighters (21%), and workers with no prior training for facing disaster. War is one of the most intense stressors known to man. Armed forces have a higher prevalence of depression, anxiety disorders, alcohol abuse and PTSD. High-risk children who have been abused or experienced natural disasters may have an even higher prevalence of PTSD than adults.Female gender, previous psychiatric problem, intensity and nature of exposure to the traumatic event, and lack of social support are known risk factors for work-related PTSD. Working with
Researchers have agreed that most rape victims vii experience stress-related symptoms similar to post-traumatic stress disorder. There have also been numerous studies that have tried to predict the severity of those stress-related symptoms, but the literature is inconclusive. Lack of perceived control is consistently mentioned in the rape research literature as being present in rape victims, but no study has empirically examined the relationship between perceived control and a rape victim's s...
Estrés postraumático y abuso sexual: Estudio descriptivo en víctimas denunciantes, Bucaramanga 2007-2008 Posttraumatic stress disorder and sexual abuse: Descriptive Study in Informing victims, Bucaramanga, Colombia 2007-2008
Miguel Enrique Ochoa
Full Text Available Introducción: El trastorno de estrés postraumático es la principal perturbación psíquica en víctimas de abuso sexual. Existen asociaciones significativas entre la edad y el género de la víctima, relación con el victimario, la penetración y el trastorno; sin embargo, la evidencia sobre el efecto de la mayoría de factores de riesgo es aún controversial. Este estudio inicial describe dichas características en una población denunciante con y sin este trastorno.Metodología: Estudio descriptivo en 175 víctimas de abuso sexual que acuden a peritaje al la Regional Nororiente Instituto Nacional de Medicina Legal y Ciencias Forenses en Bucaramanga, entrevistados por psiquiatría forense durante 1 año. Se presentan medidas de tendencia central y frecuencia. Resultados: La mayoría de denunciantes eran mujeres entre los 5 y los 14 años. El 79% de los casos provenían de estrato 1 y 2. Solo la tercera parte fueron denunciados desde el primer episodio. El 88% eran menores de edad. El 95% de los abusadores eran conocidos o parientes. Aproximadamente la mitad de los abusos incluyeron acceso carnal. 2 de cada 5 víctimas presentaron Trastorno por estrés postraumático. Discusión: El abuso sexual en nuestra población es denunciado principalmente en niñas y adolescentes, generalmente es de agresor único, y en congruencia con otros estudios, suele ser crónico y con secuelas psíquicas en más de un tercio de las víctimas. El agresor generalmente es un conocido, o un familiar, y rara vez, un desconocido. Hay que tener en cuenta que lo anteriormente descrito sólo caracteriza a la población denunciante. Salud UIS 2010; 42: 25-33Introduction: Posttraumatic stress disorder is the principal psychological diagnosis in sexual abuse victims. Although its significant associations with victims age and gender, parental relationship with the aggressor and the type of sexual intercourse, the evidence regarding the effect of the majority of risk factors
Resnick, Heidi; Zuromski, Kelly L; Galea, Sandro; Price, Matthew; Gilmore, Amanda K; Kilpatrick, Dean G; Ruggiero, Kenneth
The purpose of the current report was to examine prior history of exposure to interpersonal violence (IPV), as compared with prior accident or prior disaster exposure, experiences during and after a disaster, and demographic variables as predictors of past month posttraumatic stress disorder (PTSD) and depression severity among adolescents exposed to the tornadoes in Alabama and Missouri. IPV exposure has been consistently identified as a unique category of potentially traumatic events (PTE) that significantly increases risk for development of PTSD and other difficulties relative to other event types among adolescents. A population-based sample of adolescents and caregivers ( N = 2,000) were recruited randomly from tornado-affected communities in Alabama and Joplin, Missouri. Participants completed structured telephone interviews on an average of 8.8 months posttornado. Prior history of IPV was prevalent (36.5%), as was reported history of accidents (25.9%) and prior disaster exposure (26.9%). Negative binomial regression analyses with PTSD and depression symptom counts for past month as outcome variables indicated that history of predisaster IPV was most robustly related to PTSD and depression symptoms, such that those with a history of IPV endorsed over 3 times the number of symptoms than those without IPV history. Final model statistics indicated that female gender, physical injury to caregiver, concern about others' safety, prior disaster, prior accident, and prior IPV exposure were also related to PTSD. Predictors of depression symptoms were similar with the exception that concern about others' safety was not a predictor and age was a predictor in the final model. It is important to evaluate potential additive effects of IPV history in addition to recent disaster exposure variables and to consider such history when developing interventions aimed to reduce or prevent symptoms of PTSD and depression among adolescents recently exposed to disaster.
Pigeon, Wilfred R; Gallegos, Autumn M
The purpose of this article is to provide a brief overview of sleep in the context of posttraumatic stress disorder (PTSD) and focus on the treatment of the most common sleep disorders encountered by patients with PTSD: insomnia and nightmares. The effects of the standard treatments for PTSD are discussed along with a review of available treatments for insomnia and nightmares. Particular emphasis is placed on nonpharmacologic treatments for these sleep disorders and how they may be adapted for delivery to patients with PTSD. Published by Elsevier Inc.
Ramberg, Maria; Stanley, Barbara; Ystgaard, Mette; Mehlum, Lars
Posttraumatic stress disorder and major depressive disorder are well-established risk factors for suicidal behavior. This study compared depressed suicide attempters with and without comorbid posttraumatic stress disorder with respect to additional diagnoses, global functioning, depressive symptoms, substance abuse, history of traumatic exposure, and suicidal behavior. Adult patients consecutively admitted to a general hospital after a suicide attempt were interviewed and assessed for DSM-IV diagnosis and clinical correlates. Sixty-four patients (71%) were diagnosed with depression; of them, 21 patients (32%) had posttraumatic stress disorder. There were no group differences in social adjustment, depressive symptoms, or suicidal intent. However, the group with comorbid depression and posttraumatic stress disorder had more additional Axis I diagnoses, a higher degree of childhood trauma exposure, and more often reported previous suicide attempts, non-suicidal self-harm, and vengeful suicidal motives. These findings underline the clinical importance of diagnosis and treatment of posttraumatic stress disorder in suicide attempters.
Full Text Available Objective. To determine sleep disorders and posttraumatic stress symptoms in a group of raped female victims and to assess the causal influence by a survey of the association between exposed and unexposed groups and compare those events. Material and Methods. A prospective analytic doublegroup study. Sample of raped women selected according to inclusion and exclusion criteria, which went to a Forensic Medicine Institute. A group of nonexposed women matched by age, gender, socioeconomic status, location, timing, and status was selected. We applied the Pittsburgh Sleep Quality Index, the Epworth Sleepiness Scale, and the Impact of Event Scale. Results. Data distribution was not normal. Size, weight, and BMI were similar in both groups. We found statistically significant differences in the total score of the sleep quality variables, subjective quality, efficiency and sleep disturbances, awakening early in the morning, not breathing, coughing or snoring, feeling too cold, feeling too hot, nightmares, use of hypnotics, daytime dysfunction and posttraumatic stress symptoms. Conclusions. The presence of sleep disorders and posttraumatic stress symptoms in victims of rape are significant compared with a matched group of nonraped women in Bogotá.Objetivo. determinar alteraciones del sueño y síntomas por estrés postraumático en una cohorte de mujeres víctimas de asalto sexual y evaluar la influencia causal mediante la mensura de la asociación entre exposición y comparar eventos con un grupo de no expuestas. Materiales y Métodos. estudio de doble cohorte prospectivo. Muestra de mujeres asaltadas sexualmente seleccionadas según criterios de inclusión y exclusión, que acudieron a valoraciones médico legales y una cohorte no expuesta pareada por edad, género, estrato socioeconómico, lugar, temporalidad y estado civil. Se aplicó el Índice de Calidad del Sueño de Pittsburg, la Escala de Somnolencia de Epworth y la Escala de Impacto de Eventos
... overexcited. Trouble sleeping. Feeling detached from oneself or reality. Patients may also have feelings of shock, fear, ... It is not completely clear who has an increased risk of cancer-related post-traumatic stress . Certain ...
Since the diagnosis of posttraumatic stress disorder (PTSD) was introduced in DSM-III in 1980, a variety of psychotherapeutic approaches have been developed to address the specific problems and needs of traumatized patients. Successful treatment of PTSD requires a well thought-out therapeutic attitude. The therapist must find a well-balanced position between over-identification and turning away out of helplessness. A sensation-seeking attitude should be avoided as should the danger of vicarious traumatisation. In many instances, PTSD can not be treated sufficiently by psychotherapy alone: a comprehensive, multi-modal treatment plan may include pharmacotherapeutic, physical, social, legal, and other interventions. Early psychotherapeutic interventions in the immediate aftermath of a traumatic event follow the rules of crisis intervention (immediacy, focus on the current problems, time limitation). Special attention should be paid to the issues of developing a trusting therapeutic relationship, creating an atmosphere of safety, helping the patient to regain control over and/or distance himself from intrusive recollections. Eye Movement Desensitization and Reprocessing (EMDR) and other "power therapies" can offer quick relief from symptoms. After collective traumatization, psychological debriefings are widely used although the evidence for their usefulness in preventing PTSD is questionable. In patients with chronic PTSD, the psychotherapist should not work exclusively on the traumatic event and its sequelae: treatment should be oriented towards the future rather than the past. Instead of exploring, the therapist should try to activate the patients' resources and help them to find new meaning in their future life.
Kreiner, Barbara; Sulyok, Christoph; Rothenhäusler, Hans-Bernd
Previous research has documented that a variety of anxiety, depressive, and psychosomatic symptoms are present in a substantial portion of mobbing victims. This study aimed to explore the frequency of posttraumatic stress disorder (PTSD) among mobbing victims, and to investigate how PTSD was linked to pertinent psychometric scales. We recruited 20 mobbing victims and conducted the Structural Clinical Interview (SCID) to assess PTSD according to DSM-IV criteria. The trauma criterion was homogeneously defined as mobbing. 55% of our entire sample had a current PTSD, and 70% suffered from severe posttraumatic stress symptoms according to the Impact of Event Scale. Using multivariate analysis of variance (MANOVA), we found that mobbing victims with a current PTSD tended to demonstrate higher levels of stress and depressive symptoms, and less quality of life (SF 36 Short-Form Health Survey), especially in terms of bodily pain, compared with those without a PTSD diagnosis. No significant differences in personality factors (Freiburg Personality Inventory) between mobbing-victims with and without PTSD were evident by multivariate analysis. Univariate statistics, however, revealed that mobbing-related PTSD showed a trend towards higher scores in social orientation and somatic complaints. There was no general evidence that mobbing victims with a PTSD used more often negative and positive coping strategies (SVF - Stress Coping Questionnaire). However, they showed a tendency to employ control strategies, avoidance, social withdrawal, and cognitive preoccupation. Posttraumatic stress disorder subsequent to mobbing can occur frequently. PTSD therefore should be specifically considered in routine care.
Olde, E.; Hart, O. van der; Kleber, R.J.; Son, M.J.M. van
To assess the empirical basis of prevalence and risk factors of childbirth-related posttraumatic stress symptoms and PTSD in mothers, the relevant literature was critically reviewed. A MEDLINE and PSYCHLIT search using the key words bposttraumatic stressQ, bPTSDQ, bchildbirthQ and btraumatic
Taylor, Kathryn M; Sharpe, Louise
International studies indicate high prevalence rates of post-traumatic stress disorder within homeless populations. In Australia, studies indicate high rates of trauma among homeless adults, yet post-traumatic stress disorder has not been investigated in homeless Australian adults. The primary aim of this project was to determine the prevalence of post-traumatic stress disorder among homeless adults in Sydney. Further, another aim of the study was to determine whether the onset of post-traumatic stress disorder preceded the first episode of homelessness or was a consequence of homelessness. The sample consisted of 70 homeless men and women aged 18-73 years, who were randomly sampled through eight homeless services. A computer-assisted face-to-face structured clinical interview was conducted with each participant. Lifetime prevalence of post-traumatic stress disorder was determined via the Composite International Diagnostic Interview. The majority of the sample had experienced at least one traumatic event in their lifetime (98%). Indeed, the mean number of traumas per person was six. The 12 month prevalence of post-traumatic stress disorder was higher among homeless adults in Sydney in comparison to the Australian general population (41% vs 1.5%). But 79% of the sample had a lifetime prevalence of post-traumatic stress. In 59% of cases, the onset of post-traumatic stress disorder preceded the age of the first reported homeless episode. Homeless adults in Sydney frequently experience trauma and post-traumatic stress disorder. The study found that trauma and post-traumatic stress disorder more often precede homelessness, but re-victimization is common. These findings highlight the high mental health needs among homeless people and have implications for services for homeless people.
Liu, AiZhong; Tan, Hongzhuan; Zhou, Jia; Li, Shuoqi; Yang, Tubao; Sun, Zhenqiu; Wen, Shi Wu
The objective of this paper is to develop a brief screening instrument of posttraumatic stress disorder (PTSD) for young victims of natural disasters. Data were derived from flood victims in 1998 and 1999 in Hunan, China. A representative population sample of 6,852 subjects 7-15 years of age was selected. Among them, 6,073 (88.6%) were…
Yehuda, Rachel; Golier, Julia A; Halligan, Sarah L; Harvey, Philip D
Impairments in explicit memory have been observed in Holocaust survivors with posttraumatic stress disorder. To evaluate which memory components are preferentially affected, the California Verbal Learning Test was administered to Holocaust survivors with (n = 36) and without (n = 26) posttraumatic stress disorder, and subjects not exposed to the Holocaust (n = 40). Posttraumatic stress disorder subjects showed impairments in learning and short-term and delayed retention compared to nonexposed subjects; survivors without posttraumatic stress disorder did not. Impairments in learning, but not retention, were retained after controlling for intelligence quotient. Older age was associated with poorer learning and memory performance in the posttraumatic stress disorder group only. The most robust impairment observed in posttraumatic stress disorder was in verbal learning, which may be a risk factor for or consequence of chronic posttraumatic stress disorder. The negative association between performance and age may reflect accelerated cognitive decline in posttraumatic stress disorder.
Manix, Mary M.
This paper reviews the literature published in the last 10 years that focused on posttraumatic stress disorder (PTSD) in children exposed to man-made disasters such as war, school shootings, and the Oklahoma City bombing. As mass violence continues in society, mental health professionals need to be prepared to treat child victims of such…
changes by genetic background has been reported in the literature; for example, C57BL/6j is more susceptible to diet -induced atherosclerosis than the...victims of the Tokyo subway sarin poisoning : A relation with post-traumatic stress disorder. Neurosci Res 44(3):267–272. 8. Geracioti TD, Jr., et al
Introduction. Posttraumatic stress disorder (PTSD) is characterised by a constellation of symptoms, which may be distressing and impairing, after experiencing or being confronted with a traumatic event that includes an actual or perceived threat to self or others.1. Symptoms involve repeated and intrusive memories related ...
Purpose : This study examined the comorbidity of whiplash and post-traumatic stress disorder (PTSD) following motor vehicle accidents. A treatment strategy in cases with both disorders is proposed. Method: A review of the literature on psychological consequences of motor vehicle accidents and on
Gillespie, Gordon Lee; Bresler, Scott; Gates, Donna M; Succop, Paul
Workplace aggression has the potential to adversely affect the psychological health of emergency department (ED) workers. The purpose of this study was to compare posttraumatic stress symptomatology based on verbal and verbal plus physical aggression. A descriptive cross-sectional design was used with a convenience sample (n = 208) of ED workers who completed a three-component survey. Descriptive statistics were computed to compare traumatic stress scores based on type of aggression. Two-way analysis of variance statistics were computed to determine if scores differed on the demographic variables. Fewer than half of the ED workers reported traumatic stress symptomatology; however, workplace aggression has the potential to adversely affect the mental health of ED workers. Occupational health nurses can establish or maintain a nurturing and protective environment open to discussing the personal thoughts, feelings, and behaviors of ED workers related to their experiences of workplace aggression. This open and more positive work environment may aid in reducing the negative impact of posttraumatic stress symptoms among those ED workers who have been victimized. Copyright 2013, SLACK Incorporated.
Löfving-Gupta, Sandra; Lindblad, Frank; Stickley, Andrew; Schwab-Stone, Mary; Ruchkin, Vladislav
The psychological effects of community violence exposure among inner-city youth are severe, yet little is known about its prevalence and moderators among suburban middle-class youth. This study aimed to assess the prevalence of community violence exposure among suburban American youth, to examine associated posttraumatic stress and to evaluate factors related to severe vs. less severe posttraumatic stress, such as co-existing internalizing and externalizing problems, as well as the effects of teacher support, parental warmth and support, perceived neighborhood safety and conventional involvement in this context. Data were collected from 780 suburban, predominantly Caucasian middle-class high-school adolescents in the Northeastern US during the Social and Health Assessment (SAHA) study. A substantial number of suburban youth were exposed to community violence and 24% of those victimized by community violence developed severe posttraumatic stress. Depressive symptoms were strongly associated with higher levels and perceived teacher support with lower levels of posttraumatic stress. Similar to urban youth, youth living in suburban areas in North American settings may be affected by community violence. A substantial proportion of these youth reports severe posttraumatic stress and high levels of comorbid depressive symptoms. Teacher support may have a protective effect against severe posttraumatic stress and thus needs to be further assessed as a potential factor that can be used to mitigate the detrimental effects of violence exposure.
Jaquier, Véronique; Flanagan, Julianne C; Sullivan, Tami P
Although intimate partner violence (IPV) has demonstrated strong associations with anxiety and posttraumatic stress, these constructs have rarely been examined simultaneously in IPV research. Gaps in knowledge remain as to their differential associations to substance use problems among IPV-victimized women. A sample of 143 community women self-reported on their current IPV victimization, mental health and substance use problems. Hierarchical entry multiple regressions were used to test for the direct and indirect effects of psychological, physical, and sexual IPV to alcohol and drug problems through anxiety and posttraumatic stress. Higher anxiety symptom severity and higher physical IPV severity were associated with greater alcohol and drug problems. Higher posttraumatic stress symptom severity was associated with greater alcohol and drug problems. Mediation analyses indicated (i) significant indirect pathways of IPV types to alcohol problems through posttraumatic stress symptom severity controlling for anxiety symptom severity and (ii) significant indirect pathways of IPV types to drug problems through anxiety symptom severity controlling for posttraumatic stress symptom severity. In examining the indirect pathways of psychological, physical, and sexual IPV to substance use problems this study highlights that anxiety and posttraumatic stress symptom severity have unique effects on alcohol and drug problems among IPV-victimized women.
Grasso, Damion; Boonsiri, Joseph; Lipschitz, Deborah; Guyer, Amanda; Houshyar, Shadi; Douglas-Palumberi, Heather; Massey, Johari; Kaufman, Joan
Posttraumatic stress disorder (PTSD) is frequently under-diagnosed in maltreated samples. Protective services information is critical for obtaining complete trauma histories and determining whether to survey PTSD symptoms in maltreated children. In the current study, without protective services information to supplement parent and child report, the diagnosis of PTSD was missed in a significant proportion of the cases. Collaboration between mental health professionals and protective service wo...
Veenema, Tener Goodwin; Schroeder-Bruce, Kathryn
Terrorist attacks, situations of armed conflict, and all forms of catastrophe tax our abilities to cope, understand, and respond. Because of their developmental status, children are even more emotionally vulnerable to the devastating effects of a disaster. When tragedy strikes a family, community, or the nation, helping children cope and regain a sense of safety is critical. A child with posttraumatic stress disorder (PTSD) develops symptoms such as intense fear, disorganized and agitated behavior, emotional numbness, anxiety, or depression after being directly exposed to or witnessing an extreme traumatic situation involving threatened death or serious injury. Victims of repeated abuse or children who live in violent neighborhoods or war zones, or who have witnessed extensive media coverage of violent events, may experience PTSD.
... events and children (Medical Encyclopedia) Also in Spanish Topic Image MedlinePlus Email Updates Get Post-Traumatic Stress ... stress disorder Traumatic events and children Related Health Topics Stress Veterans and Military Health National Institutes of ...
Schiechtl, B; Hunger, M S; Schwappach, D L; Schmidt, C E; Padosch, S A
Critical incidents in clinical medicine can have far-reaching consequences on patient health. In cases of severe medical errors they can seriously harm the patient or even lead to death. The involvement in such an event can result in a stress reaction, a so-called acute posttraumatic stress disorder in the healthcare provider, the so-called second victim of an adverse event. Psychological distress may not only have a long lasting impact on quality of life of the physician or caregiver involved but it may also affect the ability to provide safe patient care in the aftermath of adverse events. A literature review was performed to obtain information on care giver responses to medical errors and to determine possible supportive strategies to mitigate negative consequences of an adverse event on the second victim. An internet search and a search in Medline/Pubmed for scientific studies were conducted using the key words "second victim, "medical error", "critical incident stress management" (CISM) and "critical incident stress reporting system" (CIRS). Sources from academic medical societies and public institutions which offer crisis management programs where analyzed. The data were sorted by main categories and relevance for hospitals. Analysis was carried out using descriptive measures. In disaster medicine and aviation navigation services the implementation of a CISM program is an efficient intervention to help staff to recover after a traumatic event and to return to normal functioning and behavior. Several other concepts for a clinical crisis management plan were identified. The integration of CISM and CISM-related programs in a clinical setting may provide efficient support in an acute crisis and may help the caregiver to deal effectively with future error events and employee safety.
Sattler, David N; Boyd, Bill; Kirsch, Julie
This project examines protective factors associated with resilience/posttraumatic growth and risk factors associated with posttraumatic stress among firefighters exposed to critical incidents. The participants were 286 (257 men and 29 women) volunteer and paid firefighters in Whatcom County, Washington. Participants completed an anonymous survey asking about demographics, critical incident exposure, posttraumatic stress symptoms, posttraumatic growth, resource availability, coping, occupational stress and critical incident stress debriefing experience. Most participants had significant critical incident exposure, and about half had attended critical incident stress debriefing sessions. Posttraumatic growth was associated with being female, critical incident exposure, critical incident stress debriefing attendance, posttraumatic stress symptoms (negative association), occupational support, occupation satisfaction, occupational effort, problem-focused coping, emotion-focused coping and personal characteristic resources. Posttraumatic stress symptoms were positively associated with years of firefighting, burnout, occupational effort and disengagement coping and negatively associated with critical incident stress debriefing attendance, posttraumatic growth, social support, internal locus of control, personal characteristic resources, energy resources and condition resources. The findings support conservation of resources stress theory and show that the maintenance and acquisition of resources can offset losses and facilitate resilience/posttraumatic growth. Implications of the findings for enhancing firefighter resources, facilitating resilience and minimizing occupational stressors are discussed. © 2014 John Wiley & Sons, Ltd.
Heilmann, Kristine Rysst; Måkestad, Elida
Narrative Exposure Therapy (NET) is a treatment method defined as a standardized, short-term intervention for treating posttraumatic stress disorder (PTSD). NET has mainly been applied on victims of organized violence and whose life conditions are threatening and unsafe. There are no published studies of NET applied on PTSD patients living in Norway with another trauma history than war-traumas. Aim of the study: To investigate the effect of NET on diagnosed PTSD symptoms, general psychologica...
Full Text Available Development of psychiatric diseases such as posttraumatic stress disorder (PTSD invokes, as with most complex diseases, both genetic and environmental factors. The era of genome-wide high throughput technologies has sparked the initiation of genotype screenings in large cohorts of diseased and control individuals, but had limited success in identification of disease causing genetic variants. It has become evident that these efforts at the genomic level need to be complemented with endeavours in elucidating the proteome, transcriptome and epigenetic profiles. Epigenetics is attractive in particular because there is accumulating evidence that the lasting impact of adverse life events is reflected in certain covalent modifications of the chromatin.
Johannessen, Kim Berg; Berntsen, Dorthe
Posttraumatic Stress Disorder (PTSD) has frequently been found to have an impact on the development of obesity, with the relationship between past traumatic episodes and obesity usually thought of as uni-directional. The purpose of the present study was to examine whether the level of PTSD......-symptoms would decrease as a result of weight loss in obese participants during a 16 week stay at a weight loss facility. During the 16 weeks participants’ Body Mass Index (BMI) decreased significantly. Concurrently, a significant decline in the level of PTSD symptoms was also reported. During the first week...
Full Text Available In the form of the Transcendental Meditation program CAM offers a method of eliminating deep-rooted stress, the efficacy of which has been demonstrated in several related studies. Any discussion of CAM and post-traumatic stress disorder should include a study of its application to Vietnam War Veterans in which improvements were observed on all variables, and several participants were able to return to work after several years of being unable to hold a job. The intervention has been studied for its impact on brain and autonomic nervous system function. It has been found to be highly effective against other stress-related conditions such as hypertension, and to improve brain coherence—a measure of effective brain function. It should be considered a possible ‘new and improved mode of treatment’ for PTSD, and further studies of its application made.
Schoedl, Aline F; Costa, Mariana P; Fossaluza, Victor; Mari, Jair J; Mello, Marcelo F
To evaluate differences in early life events (ELE) on adult victims of severe interpersonal violence among patients who developed posttraumatic stress disorder (PTSD) and control group. Adult victims of interpersonal violence were evaluated to diagnose the presence of PTSD and ELE. 308 subjects were included, 141 in patient's group (PTSD+) and 167 in control group (PSTD-). PTSD+ group had more severe PTSD, depressive symptoms and higher ETI scores than PTSD- group. Patients in PTSD+ group had a more frequent history of ELE. Some ELE were more significant for the development of this predisposition. © The Author(s) 2013.
Gauthier-Duchesne, Amélie; Hébert, Martine; Daspe, Marie-Ève
Despite the proliferation of studies documenting outcomes in sexually abused victims, gender differences remain understudied. The bulk of studies have relied on retrospective samples of adults with insufficient representation of male victims to explore gender specificities. This study examined differential outcomes among boy and girl victims of sexual abuse. A predictive model of outcomes including abuse characteristics and sense of guilt as mediators was proposed. Path analysis was conducted with a sample of 447 sexually abused children (319 girls and 128 boys), aged 6-12. Being a girl was a predictor of posttraumatic stress symptoms, while being a boy was a predictor of externalizing problems. Being a boy was also associated with more severe abuse, which in turn predicted posttraumatic stress symptoms. Child's gender was not related to perpetrator's relationship to the child or sense of guilt. However, sense of guilt predicted posttraumatic stress symptoms and externalizing problems while perpetrator's relationship to the child predicted externalizing problems. Gender specificities should be further studied among sexually abused children, as boys and girls appear to manifest different outcomes. Sense of guilt should be a target in intervention for sexually abused children, as results highlight its link to heightened negative outcomes. Copyright © 2016 Elsevier Ltd. All rights reserved.
Usta, Mirac Baris; Tuncel, Ozgur Korhan; Akbas, Seher; Aydin, Berna; Say, Gokce Nur
Recent evidence shows that the hypothalamic-pituitary-adrenal (HPA) axis can be dysregulated in chronic sexual abuse victims with post-traumatic stress disorder (PTSD). We hypothesized that PTSD in adolescents exposed to a single sexual trauma may function as a chronic stressor leading to HPA-axis dysregulation. The objective of this study was to assess dehydroepiandrosterone sulphate (DHEA-S) and cortisol levels in female adolescents |with single sexual trauma-related PTSD compared to healthy controls. We assessed 20 female adolescent (age 12-18) single sexual trauma victims with PTSD from the Ondokuz Mayis University Department of Child and Adolescent Psychiatry between December 2013 and December 2014. PTSD symptoms were assessed using the Child Depression Inventory (CDI) and Child Posttraumatic Stress Reaction Index (CPSRI). Blood cortisol and DHEA-S were measured in 20 female adolescent sexual abuse victims with PTSD and 20 healthy adolescents after 12-h fasting using the chemiluminescence method. Compared to age-matched controls, female adolescent sexual abuse victims with PTSD had significantly lower DHEA-S levels (U = 70.00, Z = - 3.517, p = 0.01, r = 0.55). There was also a significant negative correlation between DHEA-S and CDI scores (Spearman r = - 0.522, p adolescent single sexual trauma victims with PTSD. Further research is now recommended with large patient groups in order to maximize generalizations.
Avant, Elizabeth M.; Swopes, Rachel M.; Davis, Joanne L.; Elhai, Jon D.
Research suggests that among college students, physical and sexual abuse in intimate relationships are associated with posttraumatic stress. Psychological abuse occurs in intimate relationships among college students, and though there is evidence that such abuse has a negative emotional impact, posttraumatic stress has not been extensively…
Ullman, Sarah E.; Najdowski, Cynthia J.; Filipas, Henrietta H.
This study examined the unique effects of child sexual abuse simultaneously with post-traumatic stress disorder symptom clusters, problem drinking, and illicit drug use in relation to sexual revictimization in a community sample of female adult sexual assault victims. Participants (N = 555) completed two surveys a year apart. Child sexual abuse…
Green, Arthur H.; And Others
Case histories of four women who developed symptoms of posttraumatic stress disorder after learning of their daughters' sexual abuse are presented. The women also exhibited depression and personality disorders. Their children's abuse catalyzed a reliving of their own childhood victimization. Case psychodynamics and treatment strategies are…
Levrier; Marchand; Belleville; Dominic; Guay
Background Up to 71% of trauma victims diagnosed with PTSD have frequent nightmares (NM), compared to only 2% to 5% of the general population. Objectives The present study examined whether nightmares before the beginning of cognitive behavior therapy (CBT) for post-traumatic stress disorder (PTSD) could influence overall PTSD symptom reduction for 71 individuals with PTSD and different types of traumatic events. ...
Koutná, Veronika; Jelínek, Martin; Blatný, Marek; Kepák, T.
Roč. 9, č. 3 (2017), s. 1-11, č. článku 26. ISSN 2072-6694 R&D Projects: GA ČR(CZ) GAP407/11/2421 Institutional support: RVO:68081740 Keywords : posttraumatic stress * posttraumatic growth * benefit finding * childhood cancer survivors Subject RIV: AN - Psychology OBOR OECD: Psychology (including human - machine relations)
Ying, Liuhua; Wang, Yanli; Lin, Chongde; Chen, Chuansheng
The current study examined the longitudinal association between posttraumatic stress disorder (PTSD) symptoms and posttraumatic growth (PTG) as well as the moderating role of trait resilience in that association. Participants completed measures of PTSD symptoms, PTG, and trait resilience at 12, 18, and 24 months after the Wenchuan earthquake.…
Bliese, Paul D.; Wright, Kathleen M.; Adler, Amy B.; Cabrera, Oscar; Castro, Carl A.; Hoge, Charles W.
The purpose of the research was to assess the diagnostic efficiency of the Primary Care Posttraumatic Stress Disorder Screen (PC-PTSD) and the Posttraumatic Stress Disorder Checklist (PCL) as clinical screening tools for active duty soldiers recently returned from a combat deployment. A secondary goal was to examine the item-level characteristics…
Background Experiencing potentially traumatic events is associated with psychological distress. However, some survivors also experience positive personal and psychological changes in the aftermath of trauma. Methods The present study investigated perceived posttraumatic growth in 197 ministerial employees who were present at work during the 2011 Oslo bombing attack. The relationships between trauma-exposure, peritraumatic reactions and posttraumatic growth were studied. Moreover, the adaptive significance of posttraumatic growth was addressed. Results The results showed that higher levels of trauma-exposure and immediate reactions were significantly related to perceived posttraumatic growth. No support for an adaptive significance of posttraumatic growth was found. On the contrary, posttraumatic growth was associated with higher symptom levels of posttraumatic stress. After adjusting for posttraumatic stress symptoms no association was found between perceived growth and work and social adjustment. However, perceived growth was associated with higher levels of life satisfaction. Conclusion The present results are in line with previous findings indicating that perceived growth may be unrelated to psychological adjustment, and suggest that the concept and significance of posttraumatic growth should be interpreted with caution. PMID:24088369
Johannessen, Kim Berg; Berntsen, Dorthe
of depression also declined, whereas perceived social support was stable. The fact that the level of PTSD symptoms decreases simultaneously with weight loss is an interesting and positive side effect that has not been reported previously. The findings are discussed in term of cognitive theories of PTSD.......Posttraumatic Stress Disorder (PTSD) has frequently been found to have a significant impact on the development of obesity. Yet, while a reciprocal relationship has been found between obesity and depression, the relationship between past traumatic episodes and obesity is usually thought of as uni......, a significant decline in the level of PTSD symptoms was also reported. During the first week of treatment, 17 participants (57%) qualified for the diagnosis of PTSD when measured by a standardised checklist for PTSD symptoms. By week 16, only 6 participants (20%) qualified for the PTSD diagnosis. Level...
Reiter, Karen; Andersen, Søren Bo; Lohmann, Jessica Mariana Carlsson
Neurofeedback is an alternative, noninvasive approach used in the treatment of a wide range of neuropsychiatric disorders, including posttraumatic stress disorder (PTSD). Many different neurofeedback protocols and methods exist. Likewise, PTSD is a heterogeneous disorder. To review the evidence...... on effectiveness and preferred protocol when using neurofeedback treatment on PTSD, a systematic search of PubMed, PsychInfo, Embase, and Cochrane databases was undertaken. Five studies were included in this review. Neurofeedback had a statistically significant effect in three studies. Neurobiological changes were...... reported in three studies. Interpretation of results is, however, limited by differences between the studies and several issues regarding design. The optimistic results presented here qualify neurofeedback as probably efficacious for PTSD treatment....
Davidson, J; Glover, V; Clow, A; Kudler, H; Meador, K; Sandler, M
Tribulin (endogenous monoamine oxidase inhibitor/benzodiazepine receptor binding inhibitor) output was measured in the urine of 18 patients with post-traumatic stress disorder (PTSD) and 13 controls. The level of the two inhibitory activities was highly significantly correlated in the group as a whole. There was no difference between output of either inhibitor in patients and controls. However, when the PTSD group was subdivided according to various psychometric ratings, a pattern of output did emerge. Levels of both inhibitory activities were higher in agitated compared with non-agitated subjects, and lower in extroverts compared with introverts. This finding supports the view that tribulin output is raised in conditions of greater arousal.
Wallace, Duncan; Cooper, John
Post-traumatic stress disorder occurs in people exposed to life-threatening trauma. GPs may be seeing more patients with post-traumatic stress disorder as military personnel return from overseas deployments. The condition can present in various ways. To reduce the likelihood of missed or delayed diagnosis GPs can screen at-risk populations. A comprehensive assessment is recommended. Specialist referral may be required, particularly if there are other mental health problems. Trauma-focused psychological therapies should be offered as the first line of treatment for post-traumatic stress disorder. Usually 8-12 sessions are needed for a therapeutic effect. If drug treatment is needed, selective serotonin reuptake inhibitors are the first line. Other drugs used in post-traumatic stress disorder include antipsychotics, anticonvulsants and prazosin.
van Emmerik, A.A.P.; Reijntjes, A.; Kamphuis, J.H.
Background: Face-to-face psychological treatments have difficulty meeting today’s growing mental health needs. For the highly prevalent posttraumatic stress (PTS) conditions, accumulating evidence suggests that writing therapy may constitute an efficient treatment modality, especially when
Duan, H.; Wang, L.; Fernandez, G.S.E.; Zhang, K.; Wu, J.
Altered anticipation processes are implicated across various clinical samples, but few studies focused on the posttraumatic stress disorder (PTSD). We measured contingent negative variation (CNV) in a choice reaction paradigm among 58 survivors of the Wenchuan earthquake, including 28 individuals
Thomson, Paula; Jaque, S Victoria
This study investigated the prevalence of posttraumatic stress disorder (PTSD) in pre-professional and professional dancers (n=209) who were exposed to traumatic events. Nine self-report instruments assessed (1) adverse childhood experiences, (2) past traumatic events, (3) coping strategies under stressful situations, and (4) fantasy proneness. The psychopathology variables included (5) anxiety, (6) depression, (7) dissociation, (8) shame, and (9)) PTSD diagnostic scale. Statistical calculations included descriptive, distributional, and multivariate analysis of covariates (MANCOVA). Results indicate that dancers had a significantly higher distribution of PTSD (20.2%) compared to the normal population (7.8%). They also had a higher frequency of family members with mental illness, an inability to speak about their trauma, and more suicidal thoughts. The PTSD group of dancers had higher levels of psychopathology (anxiety, depression, dissociation, and shame) and they had more childhood adversity and adult trauma. Compared to the no-PTSD group, the PTSD group had higher scores on fantasy proneness and emotion-oriented coping strategies. These coping strategies may increase psychological instability. Addressing early abuse and trauma is recommended. Clinicians may help dancers alter their internal working models that their self is worthless, others are abusive, and the world is threatening and dangerous. By understanding PTSD in dancers, medical and mental health treatment protocols may be established to address the debilitating, and often hidden, symptoms of PTSD.
Taner Oznur; Mehmet Toygar; Bulent Karaahmetoglu; Havva Oznur; Abdullah Bolu; Barbaros Ozdemir
AIM: High levels of anger and aggression in post-traumatic stress disorder lead to unfavorable social, legal, physical and economic results to family members and the other social layers as much as patients. In this study, it is aimed to investigate the relation between both alcohol-cigarette consumption ratios and anger levels, characteristics of aggressive behaviors and the judicial outcome in cases diagnosed post-traumatic stress disorder due to armed conflict. METHODS: 38 cases diagnos...
Patel, Rikinkumar S; Elmaadawi, Ahmed; Nasr, Suhayl; Haskin, John
Post-traumatic stress disorder (PTSD) is predominant amongst individuals addicted to opioids and obscures the course of illness and the treatment outcome. We report the case of a patient with major depressive disorder and opioid dependence, who experienced post-traumatic stress disorder symptoms during a recent visit to the inpatient unit. The similarity of symptoms between post-traumatic stress disorder and opioid dependence is so high that, sometimes, it is a challenge to differentiate between these conditions. Since opioid withdrawal symptoms mimic hyper vigilance, this results in an exaggeration of the response of patients with post-traumatic stress disorder. This comorbidity is associated with worse health outcomes, as its pathophysiology involves a common neurobiological circuit. Opioid substitution therapy and psychotherapeutic medications in combination with evidence-based cognitive behavioral therapy devised for individuals with comorbid post-traumatic stress disorder and opioid dependence may improve treatment outcomes in this population. Therefore, we conclude that the screening for post-traumatic stress disorder in the opioid-abusing population is crucial. To understand the underlying mechanisms for this comorbidity and to improve the treatment response, further research should be encouraged.
Full Text Available Abstract Background Severe traumatic stressors such as war, rape, or life-threatening accidents can result in a debilitating psychopathological development conceptualised as Posttraumatic Stress Disorder (PTSD. Pathological memory formation during an alarm response may set the precondition for PTSD to occur. If true, a lack of memory formation by extended unconsciousness in the course of the traumatic experience should preclude PTSD. Methods 46 patients from a neurological rehabilitation clinic were examined by means of questionnaires and structured clinical interviews. All patients had suffered a TBI due to an accident, but varied with respect to falling unconscious during the traumatic event. Results 27% of the sub-sample who were not unconscious for an extended period but only 3% (1 of 31 patients who were unconscious for more than 12 hours as a result of the accident were diagnosed as having current PTSD (P Conclusion TBI and PTSD are not mutually exclusive. However, victims of accidents are unlikely to develop a PTSD if the impact to the head had resulted in an extended period of unconsciousness.
Nordanger, Dag Ø; Breivik, Kyrre; Haugland, Bente Storm; Lehmann, Stine; Mæhle, Magne; Braarud, Hanne Cecilie; Hysing, Mari
Former studies suggest that prior exposure to adverse experiences such as violence or sexual abuse increases vulnerability to posttraumatic stress reactions in victims of subsequent trauma. However, little is known about how such a history affects responses to terror in the general adolescent population. To explore the role of prior exposure to adverse experiences as risk factors for posttraumatic stress reactions to the Oslo Terror events. We used data from 10,220 high school students in a large cross-sectional survey of adolescents in Norway that took place seven months after the Oslo Terror events. Prior exposure assessed was: direct exposure to violence, witnessing of violence, and unwanted sexual acts. We explored how these prior adversities interact with well-established risk factors such as proximity to the events, perceived life threat during the terror events, and gender. All types of prior exposure as well as the other risk factors were associated with terror-related posttraumatic stress reactions. The effects of prior adversities were, although small, independent of adolescents' proximity to the terror events. Among prior adversities, only the effect of direct exposure to violence was moderated by perceived life threat. Exposure to prior adversities increased the risk of posttraumatic stress reactions equally for both genders, but proximity to the terror events and perceived life threat increased the risk more in females. Terror events can have a more destabilizing impact on victims of prior adversities, independent of their level of exposure. The findings may be relevant to mental health workers and others providing post-trauma health care.
Dag Ø. Nordanger
Full Text Available Background: Former studies suggest that prior exposure to adverse experiences such as violence or sexual abuse increases vulnerability to posttraumatic stress reactions in victims of subsequent trauma. However, little is known about how such a history affects responses to terror in the general adolescent population. Objective: To explore the role of prior exposure to adverse experiences as risk factors for posttraumatic stress reactions to the Oslo Terror events. Method: We used data from 10,220 high school students in a large cross-sectional survey of adolescents in Norway that took place seven months after the Oslo Terror events. Prior exposure assessed was: direct exposure to violence, witnessing of violence, and unwanted sexual acts. We explored how these prior adversities interact with well-established risk factors such as proximity to the events, perceived life threat during the terror events, and gender. Results: All types of prior exposure as well as the other risk factors were associated with terror-related posttraumatic stress reactions. The effects of prior adversities were, although small, independent of adolescents’ proximity to the terror events. Among prior adversities, only the effect of direct exposure to violence was moderated by perceived life threat. Exposure to prior adversities increased the risk of posttraumatic stress reactions equally for both genders, but proximity to the terror events and perceived life threat increased the risk more in females. Conclusions: Terror events can have a more destabilizing impact on victims of prior adversities, independent of their level of exposure. The findings may be relevant to mental health workers and others providing post-trauma health care.
Mental health nursing is not the same as psychiatry, so it is important for nurses to have an understanding of the defining attributes, antecedents, consequences, model cases, and empirical referents of post-traumatic stress disorder (PTSD). Walker and Avant's (2005) method is used to guide this concept analysis of PTSD. Four attributes arise from this concept analysis, which are addressed through both the DSM-IV and DSM-5 (American Psychiatric Association, /): triggering event or events, re-experiencing, fear, and helplessness. Though a majority of the defining attributes are addressed through both versions of the DSM, a key fifth attribute arises through this concept analysis: a disruption of meaning. A better understanding of PTSD from a nursing perspective will help inform appropriate nursing interventions and prevention strategies, while expanding the knowledge synthesis and contribution of the nursing profession. A model case, borderline case, and contrary case of PTSD are provided. Discussion of the importance of a lack or loss of meaning in PTSD is included, along with exploration of transformative learning theory to inform clinical practice for nurses addressing a disruption of meaning. © 2017 NANDA International, Inc.
Aulagnier, M; Verger, P; Rouillon, F
Traumatic events are frequently followed by an acute stress reaction that may develop into a post-traumatic stress disorder. An intervention called psychological debriefing has been proposed to prevent these disorders. Although this method is widely used at present, its preventive effect is controversial. This article consist in a review of the studies which evaluated psychological debriefing efficiency in the prevention of post-traumatic stress disorder and associated disorders in adults. We carried out a bibliographical search on MEDLINE (1966-2001), PASCAL (1987-2001), EMBASE (1988-2001), FRANCIS (1984-2001) and SCIENCEDIRECT (1967-2001). The key words were posttraumatic stress disorder, debriefing, treatment, psychological follow up, and prevention. We selected the studies with the following criteria: adults, one psychological debriefing session in the Month following the event, inclusion of a control group, more than 20 persons per group and evaluation of psychological disorders with standardized instruments more than one Month after the trauma. Twenty nine studies were identified and 8 selected. Four studies did not show any intervention effect, 3 suggested a negative intervention effect, and 1 suggested a positive effect on anxiety, depressive symptoms and alcohol dependence. Psychological debriefing implies re-exposure through memory processes to the trauma, which can interfere with the natural course of adjustment and recovery. Several Authors have suggested that psychological debriefing may delay the diagnosis and thus the early treatment of post-traumatic stress disorder. Psychological debriefing may not be appropriate to all victims of every type of incident or trauma. We discuss the intervention and its design. This review did not show evidence for psychological debriefing efficiency, as a unique session, in the prevention of posttraumatic reactions. The design and the objectives may be re-examined. Further evaluations following rigorous methods are
O'Donnell, Deborah A; Roberts, William C; Schwab-Stone, Mary E
Community violence exposure among youth can lead to various negative outcomes, including post-traumatic stress symptoms. Research in the Western world indicates that a number of social support factors may moderate the relation between violence exposure and internalizing symptoms. Little research has been carried out in non-Western countries. This study aimed to fill this gap by exploring the relations among violence exposure, parental warmth, positive school climate, and post-traumatic stress reactions among youth in The Republic of The Gambia, Africa. A school-based survey of youth behaviors, feelings, attitudes, and perceptions was administered to 653 students at senior secondary schools in four Gambian communities. Students reported high levels of exposure to violence. Over half of students reported witnessing someone threatened with serious physical harm, beaten up or mugged, attacked or stabbed with a knife/piece of glass, or seriously wounded in an incident of violence. Nearly half of students reported being beaten up or mugged during the past year, and nearly a quarter reported being threatened with serious physical harm. There were no sex differences in levels of exposure. Traumatic stress symptoms were common, especially among females. Both violence witnessing and violent victimization significantly predicted post-traumatic stress symptoms, and positive school climate moderated the relationship. Among youth victimized by violence, positive school climate was most strongly correlated with lower levels of post-traumatic stress at low levels of exposure. Among youth who had witnessed violence, positive school climate was most strongly correlated with lower levels of post-traumatic stress at high levels of exposure. Community-based programs that bring together parents, schools, and youth may play an important role in combating the negative effects of some types of violence exposure among Gambian youth. Youth experiencing high levels of violent victimization
Full Text Available Objective: The purpose of the present study was to compare response inhibition and cognitive appraisal in clients with acute stress disorder, clients with posttraumatic stress disorder, and normal individuals .Method:This was a comparative study. The sample consisted of 40 clients with acute stress disorder, 40 patients with posttraumatic stress disorder, and 40 normal individuals from Mazandaran province selected through convenience sampling method. Data were collected using Composite International Diagnostic Interview, Stroop Color-Word Test, Posttraumatic Cognitions Inventory, and the Impact of Event Scale. Results:Results showed that individuals with acute stress disorder are less able to inhibit inappropriate responses and have more impaired cognitive appraisals compared to those with posttraumatic stress disorder. Moreover, results showed that response inhibition and cognitive appraisal explain 75% of the variance in posttraumatic stress disorder symptoms and 38% of the variance in posttraumatic stress disorder symptoms .Conclusion:The findings suggest that response inhibition and cognitive appraisal are two variables that influence the severity of posttraumatic stress disorder and acute stress disorder symptoms. Also, these results have important implications for pathology, prevention, and treatment of posttraumatic stress disorder and acute stress disorder
Full Text Available Abstract Women are approximately twice as likely as men to develop posttraumatic stress disorder (PTSD after trauma exposure. Mechanisms underlying this difference are not well understood. Although sleep is recognized to have a critical role in PTSD and physical and psychological health more generally, research into the role of sleep in PTSD sex differences has been only recent. In this article, we review both animal and human studies relevant to sex differences in sleep and PTSD with an emphasis on the roles of sex hormones. Sleep impairment including insomnia, trauma-related nightmares, and rapid-eye-movement (REM sleep fragmentation has been observed in individuals with chronic and developing PTSD, suggesting that sleep impairment is a characteristic of PTSD and a risk factor for its development. Preliminary findings suggested sex specific patterns of sleep alterations in developing and established PTSD. Sleep maintenance impairment in the aftermath of trauma was observed in women who subsequently developed PTSD, and greater REM sleep fragmentation soon after trauma was associated with developing PTSD in both sexes. In chronic PTSD, reduced deep sleep has been found only in men, and impaired sleep initiation and maintenance with PTSD have been found in both sexes. A limited number of studies with small samples have shown that sex hormones and their fluctuations over the menstrual cycle influenced sleep as well as fear extinction, a process hypothesized to be critical to the pathogenesis of PTSD. To further elucidate the possible relationship between the sex specific patterns of PTSD-related sleep alterations and the sexually dimorphic risk for PTSD, future studies with larger samples should comprehensively examine effects of sex hormones and the menstrual cycle on sleep responses to trauma and the risk/resilience for PTSD utilizing various methodologies including fear conditioning and extinction paradigms and animal models.
Edward J. Hickling
Full Text Available Posttraumatic stress disorder (PTSD has been a controversial diagnosis, with concerns including the sheer number of possible minimal diagnostic combinations (1,750, increasing to >10,000 theoretical possibilities in Diagnostic and Statistical Manual of Mental Disorders (5th ed. proposals. This study examined whether the theoretical combinations postulated actually occur in a large sample of military personnel. The design of the study was a retrospective examination of PTSD checklists from 3,810 participants who, based on scores, endorsed symptoms consistent with probable PTSD. Combinations of PTSD Checklist–Civilian Version (PCL-C symptom clusters were identified using data from active-duty military personnel who completed the 2005 and the 2008 Department of Defense (DoD Health Related Behaviors Among Active Duty Military Personnel Survey. The study examined (a occurrence of combinations, (b unique minimum combinations, (c most frequent combinations, and (d replication of symptom combinations and clusters. The PCL-C scores showed 1,837 unique scoring combinations, 83.5% (1,533/1,837 of the observed unique scoring combinations occurred just once. The most frequently occurring combination (17/17 endorsed accounted for 955 participants (25.1%, the second most frequent (16/17 endorsed accounted for 75 participants (2.0%. PTSD most often presented as a unique constellation of symptom clusters, either capturing symptoms while allowing for considerable variability in its presentation, reflecting different severities of the disorder, or raising concerns about the classification itself, and any future classification that Diagnostic and Statistical Manual of Mental Disorders (5th ed.; DSM-V might develop.
Edmondson, Donald; von Känel, Roland
In this paper, a first in a Series of two, we look at the evidence for an association of post-traumatic stress disorder with incident cardiovascular disease risk and the mechanisms that might cause this association, as well as the prevalence of post-traumatic stress disorder due to cardiovascular disease events and its associated prognostic risk. We discuss research done after the publication of previous relevant systematic reviews, and survey currently funded research from the two most active funders in the field: the National Institutes of Health and the US Veterans Administration. We conclude that post-traumatic stress disorder is a risk factor for incident cardiovascular disease, and a common psychiatric consequence of cardiovascular disease events that might worsen the prognosis of the cardiovascular disease. There are many candidate mechanisms for the link between post-traumatic stress disorder and cardiovascular disease, and several ongoing studies could soon point to the most important behavioural and physiological mechanisms to target in early phase intervention development. Similarly, targets are emerging for individual and environmental interventions that might offset the risk of post-traumatic stress disorder after cardiovascular disease events. Copyright © 2017 Elsevier Ltd. All rights reserved.
Self-Brown, Shannon; Lai, Betty S; Thompson, Julia E; McGill, Tia; Kelley, Mary Lou
This study examined trajectories of posttraumatic stress disorder symptoms in Hurricane Katrina affected youth. A total of 426 youth (51% female; 8-16 years old; mean age=11 years; 75% minorities) completed assessments at 4 time points post-disaster. Measures included Hurricane impact variables (initial loss/disruption and perceived life threat); history of family and community violence exposure, parent and peer social support, and post-disaster posttraumatic stress symptoms. Latent class growth analysis demonstrated that there were three distinct trajectories of posttraumatic stress disorder symptoms identified for this sample of youth (resilient, recovering, and chronic, respectively). Youth trajectories were associated with Hurricane-related initial loss/disruption, community violence, and peer social support. The results suggest that youth exposed to Hurricane Katrina have variable posttraumatic stress disorder symptom trajectories. Significant risk and protective factors were identified. Specifically, youth Hurricane and community violence exposure increased risk for a more problematic posttraumatic stress disorder symptom trajectory, while peer social support served as a protective factor for these youth. Identification of these factors suggests directions for future research as well as potential target areas for screening and intervention with disaster exposed youth. The convenience sample limits the external validity of the findings to other disaster exposed youth, and the self-report data is susceptible to response bias. Copyright © 2012 Elsevier B.V. All rights reserved.
Shen, April Chiung-Tao
This study has examined the effects that young adults' experience of dating-violence victimization can have on their manifestation of posttraumatic stress disorder (PTSD) symptoms. This study has also examined the possible roles that cultural beliefs can play in dating-violence experience, coping choices, and PTSD symptoms. This study has used self-reporting measures to collect data from a nationally stratified random sample of 1,018 college students in Taiwan. Results demonstrate that college students who had experienced dating-violence victimization reported higher levels of PTSD symptoms than those who had not. The results reveal that psychological-violence victimization and cultural beliefs have direct and indirect effects on PTSD symptoms via the mediation of young adults' use of emotion-focused coping strategies. Greater frequencies of psychological-violence victimization were associated with a greater use of emotion-focused coping, which was in turn associated with increases in PTSD symptoms. This study illustrates that traditional Chinese beliefs have played significant roles in exacerbating the risk for dating violence and PTSD, and in shaping victims' coping choices with dating violence.
Chen, Long; Liu, Aizhong
This study analyzes the incidence of posttraumatic stress disorder (PTSD) among flood victims, between different flood intensities, and between different time points after a flood. A search of several electronic literature databases was conducted to collect data on the incidence of PTSD after a flood. Loney criteria for research quality were used to evaluate the quality of selected search results. The combined incidence of PTSD was estimated using the Freeman-Tukey double arcsine transformation method. Subgroup analyses were conducted on different trauma intensities and different time points after a flood. Sensitivity analysis was performed to evaluate the impact of research quality. Fourteen articles were included in this meta-analysis, including a total of 40 600 flood victims; 3862 victims were diagnosed with PTSD. The combined incidence of PTSD was 15.74%. The subgroup analyses showed that the incidence of PTSD in victims who experienced severe and moderate flood intensity was higher than that in victims who experienced mild flood intensity. The incidence of PTSD was lower at 6 or more months after a flood (11.45%) than within 6 months (16.01%) of a flood. In conclusion, the incidence of PTSD among floods of different trauma intensities was statistically significant.
Full Text Available Research has identified appetitive aggression, i.e., the perception of committed, violent acts as appealing, exciting and fascinating, as a common phenomenon within populations living in precarious and violent circumstances. Investigating demobilized soldiers in the Democratic Republic of Congo demonstrated that violent offending is associated with appetitive aggression but not necessarily with symptoms of posttraumatic stress. In the present study we sought to replicate these results in an independent and larger sample of demobilized soldiers from Burundi. As with the Congolese ex-combatants, random forest regression revealed that the number of lifetime perpetrated violent acts is the most important predictor of appetitive aggression and the number of lifetime experienced traumatic events is the main predictor for posttraumatic stress. Perpetrated violent acts with salient cues of hunting (pursuing the victim, the sight of blood, etc. were most predictive for perceiving violent cues appealingly after demobilization. Moreover, the association of violent acts and appetitive aggression as well as traumatic events and posttraumatic stress remains strong even years after demobilization. Patterns of traumatic events and perpetrated acts as predictors for posttraumatic stress and appetitive aggression seem to be robust among different samples of ex-combatants who fought in civil wars. Psychotherapeutic interventions that address these complementary facets of combat-related disorders -- namely, posttraumatic stress and appetitive aggression -- are indispensable for a successful reintegration of those who fought in armed conflicts and to achieve a successful transition to peace.
Köbach, Anke; Nandi, Corina; Crombach, Anselm; Bambonyé, Manassé; Westner, Britta; Elbert, Thomas
Research has identified appetitive aggression, i.e., the perception of committed, violent acts as appealing, exciting and fascinating, as a common phenomenon within populations living in precarious and violent circumstances. Investigating demobilized soldiers in the Democratic Republic of Congo (DRC) demonstrated that violent offending is associated with appetitive aggression and not necessarily with symptoms of posttraumatic stress. In the present study, we sought to replicate these results in an independent and larger sample of demobilized soldiers from Burundi. As with the Congolese ex-combatants, random forest regression revealed that the number of lifetime perpetrated violent acts is the most important predictor of appetitive aggression and the number of lifetime experienced traumatic events is the main predictor for posttraumatic stress. Perpetrated violent acts with salient cues of hunting (pursuing the victim, the sight of blood, etc.) were most predictive for perceiving violent cues appealingly after demobilization. Moreover, the association of violent acts and appetitive aggression as well as traumatic events and posttraumatic stress remains strong even years after demobilization. Patterns of traumatic events and perpetrated acts as predictors for posttraumatic stress and appetitive aggression seem to be robust among different samples of ex-combatants who fought in civil wars. Psychotherapeutic interventions that address these complementary facets of combat-related disorders-namely, posttraumatic stress and appetitive aggression-are indispensable for a successful reintegration of those who fought in armed conflicts and to achieve a successful transition to peace.
For a large number of veterans, war does not end after they are removed from a combat zone. Traumatic stress affects nearly all veterans, but while the majority of veterans learn to live with their experiences, for some veterans traumatic stress seethes inside. In this dissertation posttraumatic
Following exposure to a major traumatic event like the August seventh 1998 Nairobi bomb blast various reactions occur, some of which result in stress-related psychiatric disorders. We have described one such case, and used it to illustrate the salient features of posttraumatic stress disorder. We have outlined the diagnostic ...
Karstoft, Karen-Inge; Statnikov, Alexander; Andersen, Søren B
by application of machine learning (ML) methods. METHODS: ML feature selection and prediction algorithms were applied to a prospective cohort of 561 Danish soldiers deployed to Afghanistan in 2009 to identify unique risk indicators and forecast long-term posttraumatic stress responses. RESULTS: Robust pre......BACKGROUND: Pre-deployment identification of soldiers at risk for long-term posttraumatic stress psychopathology after home coming is important to guide decisions about deployment. Early post-deployment identification can direct early interventions to those in need and thereby prevents...... the development of chronic psychopathology. Both hold significant public health benefits given large numbers of deployed soldiers, but has so far not been achieved. Here, we aim to assess the potential for pre- and early post-deployment prediction of resilience or posttraumatic stress development in soldiers...
Full Text Available Serhat Nasıroğlu,1 Veysi Çeri2 1Department of Child and Adolescent Psychiatry, Faculty of Medicine, Sakarya University, Sakarya, Turkey; 2Pendik Training and Research Hospital, Department of Child and Adolescent Psychiatry, Medical School of Marmara University, Istanbul, Turkey Aim: The aim of this investigation was to determine the frequency of mental pathologies in children and adolescents of the Yazidi minority group who immigrated to Turkey from Iraq. The refugees were asked about preventive and risk factors that occurred before and after their immigration. Subjects and methods: The sample comprised 55 children and adolescents (30 males and 25 females who were Yazidi refugees and had settled in the Uçkuyular, Oğuz, Onbaşi, and Uğurca villages of Batman, Turkey. The study was conducted 9 months after the refugees had immigrated. The participants were evaluated in their native language through a semistructured interview titled “Reliability and Validity of Schedule for Affective Disorders and Schizophrenia for School-Age Children – Present and Lifetime Version – Turkish Version”. A sociodemographic form was prepared so that investigators could understand their traumatic experiences before and after the migration and their current social conditions. All the interviews were conducted in the participants’ native language without the help of translators. The investigators filled out the sociodemographic forms. Results: Posttraumatic stress disorder (PTSD was detected in 20 children (36.4%, depression in 18 (32.7%, nocturnal enuresis in six (10.9%, and anxiety in four (7.3%. The following factors were found to be associated with depression: witnessing violence and/or death, being a girl, having older parents, being the elder child, and having multiple siblings (P<0.05. Risk factors for PTSD, depression, and comorbid conditions included witnessing violence and/or death (P<0.05. Four participants were observed to have both PTSD and
Full Text Available Posttraumatic stress disorder (PTSD is a complex, heterogeneous disorder that develops following trauma and often includes perceptual, cognitive, affective, physiological, and psychological features. PTSD is characterized by hyperarousal, intrusive thoughts, exaggerated startle response, flashbacks, nightmares, sleep disturbances, emotional numbness, and persistent avoidance of trauma-associated stimuli. The efficacy of available treatments for PTSD may result in part from relief of associated depressive and anxiety-related symptoms in addition to treatment of core symptoms that derive from reexperiencing, numbing, and hyperarousal. Diverse, heterogeneous mechanisms of action and the ability to act broadly or very locally may enable brain stimulation devices to address PTSD core symptoms in more targeted ways. To achieve this goal, specific theoretical bases derived from novel, well-designed research protocols will be necessary. Brain stimulation devices include both long-used and new electrical and magnetic devices. Electroconvulsive therapy (ECT and Cranial electrotherapy stimulation (CES have both been in use for decades; transcranial magnetic stimulation (TMS, magnetic seizure therapy (MST, deep brain stimulation (DBS, transcranial Direct Current Stimulation (tDCS, and vagus nerve stimulation (VNS have been developed recently, over approximately the past twenty years. The efficacy of brain stimulation has been demonstrated as a treatment for psychiatric and neurological disorders such as anxiety (CES, depression (ECT, CES, rTMS, VNS, DBS, obsessive-compulsive disorder (OCD (DBS, essential tremor, dystonia (DBS, epilepsy (DBS, VNS, Parkinson Disease (DBS, pain (CES, and insomnia (CES. To date, limited data on brain stimulation for PTSD offer only modest guidance. ECT has shown some efficacy in reducing comorbid depression in PTSD patients but has not been demonstrated to improve most core PTSD symptoms. CES and VNS have shown some efficacy in
Kataoka, Sheryl; Langley, Audra K; Wong, Marleen; Baweja, Shilpa; Stein, Bradley D
The prevalence of trauma exposure among youth is a major public health concern. Students who have experienced a traumatic event are at increased risk for academic, social, and emotional problems. School can be an ideal setting for mental health professionals to intervene with traumatized students, school staff, and parents both immediately following a traumatic event and when symptoms of posttraumatic stress disorder and other trauma-related mental health problems develop. This article describes evidence-based treatments for posttraumatic stress disorder and outlines practical approaches to use in schools.
Canton-Cortes, David; Canton, Jose
Objective: The purpose of this study was to examine the effects of child sexual abuse (CSA) on the use of coping strategies and post-traumatic stress disorder (PTSD) scores in young adults, as well as the role of avoidance and approach coping strategies in those PTSD scores in CSA victims. The role of coping strategies was studied by considering…
Scheeringa, Michael S.; Weems, Carl F.; Cohen, Judith A.; Amaya-Jackson, Lisa; Guthrie, Donald
Background: The evidence base for trauma-focused cognitive behavioral therapy (TF-CBT) to treat posttraumatic stress disorder (PTSD) in youth is compelling, but the number of controlled trials in very young children is few and limited to sexual abuse victims. These considerations plus theoretical limitations have led to doubts about the…
Sullivan, Tami P; Flanagan, Julianne C; Dudley, Desreen N; Holt, Laura J; Mazure, Carolyn M; McKee, Sherry A
Smoking prevalence among women who experience intimate partner violence (IPV) is two to three times higher than the prevalence among women nationally. Yet, research on cigarette smoking among this population of women is scarce. This study examined differences between daily smokers and non-smokers among a sample of 186 IPV-victimized women. Comparing these groups may identify key factors that could inform future research, and ultimately, smoking cessation interventions to improve women's health. Results showed that smokers and non-smokers differed in terms of alcohol and drug use problem severity, posttraumatic stress symptom severity, psychological and physical IPV victimization severity, and severity of use of psychological and physical IPV. Smokers fared worse on all domains where differences emerged. Findings of a logistic regression demonstrated that alcohol problem severity was related to daily smoking status; post hoc analysis revealed that the effect of alcohol problem severity was moderated by the level of Posttraumatic stress disorder (PTSD) avoidance symptom severity. Findings suggest a sub-population of women experiencing IPV who smoke and incur additional risk for psychiatric symptom severity and maladaptive behaviors. This study suggests the need to examine factors such as IPV and its negative sequelae to inform smoking cessation research for women. This study contributes to the scarce literature examining the intersections of PTSD, alcohol and drug use, and smoking. Examining these factors in the context of IPV, which is a highly prevalent problem, is critical to informing future treatment development investigations. © American Academy of Addiction Psychiatry.
Hruska, Bryce; Fallon, William; Spoonster, Eileen; Sledjeski, Eve M; Delahanty, Douglas L
Avoidance coping (AVC) is common in individuals with posttraumatic stress disorder (PTSD) and in individuals with alcohol use disorder (AUD). Given that PTSD and AUD commonly co-occur, AVC may represent a risk factor for the development of comorbid posttraumatic stress and alcohol use. In this study, the relationship between AVC and PTSD symptoms (PTSS) was examined in individuals with versus without AUDs. Motor vehicle accident (MVA) victims were assessed 6 weeks postaccident for AUD history (i.e. diagnoses of current or past alcohol abuse or dependence) and AVC. PTSS were assessed 6 weeks and 6 months post-MVA. All analyses were conducted on the full sample of MVA victims as well as on the subset of participants who were legally intoxicated (blood alcohol concentration ≥ 0.08) during the accident. It was hypothesized that the relationship between AVC and PTSS would be stronger in those individuals with an AUD history and especially strong in the subset of individuals who were legally intoxicated during the MVA. Results were largely supportive of this hypothesis, even after controlling for in-hospital PTSS, gender, and current major depression. Early assessment of AUD history and avoidance coping may aid in detecting those at elevated risk for PTSD, and intervening to reduce AVC soon after trauma may help buffer the development of PTSD + AUD comorbidity. (c) 2011 APA, all rights reserved.
Pratchett, Laura C; Yehuda, Rachel
The effects of childhood abuse are diverse, and although pathology is not the only outcome, psychiatric illness, including posttraumatic stress disorder (PTSD), can develop. However, adult PTSD is less common among those who experienced single-event traumas as children than it is among those who experienced childhood abuse. In addition, PTSD is more common among adults than children who experienced childhood abuse. Such evidence raises doubt about the direct, causal link between childhood trauma and adult PTSD. The experience of childhood trauma, and in particular abuse, has been identified as a risk factor for subsequent development of PTSD following exposure to adult trauma, and a substantial literature identifies revictimization as a factor that plays a pivotal role in this trajectory. The literature on the developmental effects of childhood abuse and pathways to revictimization, when considered in tandem with the biological effects of early stress in animal models, may provide some explanations for this. Specifically, it seems possible that permanent sensitization of the hypothalamic-pituitary-adrenal axis and behavioral outcomes are a consequence of childhood abuse, and these combine with the impact of retraumatization to sustain, perpetuate, and amplify symptomatology of those exposed to maltreatment in childhood.
At 6–8 weeks postpartum, their type of delivery was recorded, and they were then divided into two groups based on this variable. The posttraumatic stress diagnostic scale, the postpartum maternal and neonatal factors assessment, Winfield and Taigman's social support questionnaire, and the anxiety and depression ...
Siegelaar, S. E.; Olff, M.; Bour, L. J.; Veelo, D.; Zwinderman, A. H.; van Bruggen, G.; de Vries, G. J.; Raabe, S.; Cupido, C.; Koelman, J. H. T. M.; Tijssen, M. A. J.
Post-traumatic stress disorder (PTSD) patients are considered to have excessive EMG responses in the orbicularis oculi (OO) muscle and excessive autonomic responses to startling stimuli. The aim of the present study was to gain more insight into the pattern of the generalized auditory startle reflex
Kennis, M.; Van Rooij, S. J H; Van Den Heuvel, M. P.; Kahn, R. S.; Geuze, E.
Posttraumatic stress disorder (PTSD) is a disabling disorder associated with resting state functional connectivity alterations. However, whether specific brain regions are altered in PTSD or whether the whole brain network organization differs remains unclear. PTSD can be treated with trauma-focused
Background: Posttraumatic stress disorder (PTSD) is a very common mental condition and a unique anxiety disorder. Aim: The present study tried ... Data were collected using the customized screening form, the Symptom Checklist‑90, PTSD Symptom Scale (PSS), and Social Support Questionnaire. The collected data were ...
... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF VETERANS AFFAIRS 38 CFR Part 3 RIN 2900-AN32 Stressor Determinations for Posttraumatic Stress Disorder Correction In rule document 2010-16885 beginning on page 39843 in the issue of Tuesday, July 13, 2010 make the...
diseases, depression and post-traumatic stress disorder (PTSD). It also affects the capacity of women to act as equal and ... particularly depression and substance abuse. One study found that 42.9% of. Bavanisha Vythilingum .... Selective serotonin re-uptake inhibitors. (SSRIs) are a first-line medication treat- ment, both in ...
Jan 17, 2006 ... Post-traumatic stress disorder (PTSD) is an anxiety disorder that may develop after exposure to a terrifying event/ordeal in which grave physical harm occurred or was threatened. Traumatic events that can trigger PTSD include personal assaults such as rape or mugging, natural or human-caused disasters ...
A number of epidemiological studies have attempted to measure the prevalence of HIV-related posttraumatic stress disorder (PTSD) in sub-Saharan Africa. A systematic review of the literature identified eight relevant studies that put current estimates of the prevalence of HIV-related PTSD between 4.2% and 40%. Even the ...
Rubin, David C.; Berntsen, Dorthe; Johansen, Marlene Klindt
In the mnemonic model of posttraumatic stress disorder (PTSD), the current memory of a negative event, not the event itself, determines symptoms. The model is an alternative to the current event-based etiology of PTSD represented in the Diagnostic and Statistical Manual of Mental Disorders (4th ed...
Kleine, R.A. de; Hendriks, L.; Becker, E.S.; Broekman, T.G.; Minnen, A. van
Exposure therapy has proven efficacy in the treatment of posttraumatic stress disorder (PTSD). Emotional processing theory proposes that fear habituation is a central mechanism in symptom reduction, but the empirical evidence supporting this is mixed. Recently it has been proposed that violation of
Spindler, Helle; Pedersen, Susanne S.
There is increasing recognition that patients after a cardiac event may be at risk of posttraumatic stress disorder (PTSD). The present article reviews studies looking at PTSD as a sequel of heart disease with a focus on prevalence, risk factors, and future research directions....
Buhmann, Cæcilie Böck; Andersen, Henrik Steen
The post-traumatic stress disorder (PTSD) diagnosis has undergone large developments. With the changes in DSM-5 and the proposed changes in ICD-11, the two systems move in different directions. Treatment for PTSD is developing, but the evidence for the effect is lacking behind. Trauma...
Elklit, A.; Reinholt, Nina; Nielsen, Louise Hjort
The aim of this study was to assess post-traumatic stress disorder (PTSD) and predictors of PTSD in individuals who experienced the loss of a close relative to cancer. A total of 251 bereaved relatives ages 14 to 76 (M = 41.3, SD = 16.8) were recruited at a counseling service for cancer patients...
Epidemiological data specifically documenting PTSD prevalence following violence exposure in children and adolescents in South Africa is lacking. In this preliminary survey, a positive association was found between exposure to violent and multiple traumas and posttraumatic stress disorder symptoms in adolescents.
Utzon-Frank, Nicolai; Breinegaard, Nina; Bertelsen, Mette
Post-traumatic stress disorder (PTSD) develops according to consensus criteria within the first 1-6 months after a horrifying traumatic event, but it is alleged that PTSD may develop later. The objective was to review the evidence addressing occurrence of PTSD with onset >6 months after a traumatic...
This meta-analysis of 58 resting baseline studies, 25 startle studies, 17 standardized trauma cue studies, and 22 idiographic trauma cue studies compared adults with and without posttraumatic stress disorder (PTSD) on psychophysiological variables: facial electromyography (EMG), heart rate (HR), skin conductance (SC), and blood pressure.…
Context: Posttraumatic stress disorder (PTSD) is the most common consequence of traumatic experiences. The North Central Nigeria to which Plateau State belongs has witnessed many ethno‑religious crises. While previous studies suggested a high prevalence of PTSD among students, to the best of our knowledge, ...
Background: Psychological responses to traumatic events vary widely across different cultures but studies in the developing countries are scant. The objective of this study is to determine prevalence of depression and posttraumatic stress disorder (PTSD) among patients involved in road traffic accident (RTA) compared with ...
Nov 10, 2015 ... Background: Psychological responses to traumatic events vary widely across different cultures but studies in the developing countries are scant. The objective of this study is to determine prevalence of depression and posttraumatic stress disorder (PTSD) among patients involved in road traffic accident ...
Landolt, Markus A.; Vollrath, Margarete; Timm, Karin; Gnehm, Hanspeter E.; Sennhauser, Felix H.
Objective: To prospectively assess the prevalence, course, and predictors of posttraumatic stress symptoms (PTSSs) in children after road traffic accidents (RTAs). Method: Sixty-eight children (6.5-14.5 years old) were interviewed 4-6 weeks and 12 months after an RTA with the Child PTSD Reaction Index (response rate 58.6%). Their mothers (n = 60)…
A number of epidemiological studies have attempted to measure the prevalence of HIV-related posttraumatic stress disorder (PTSD) in sub-Saharan Africa. A systematic ... Even the lower estimates suggest that PTSD in response to the trauma of being diagnosed and living with HIV is a significant mental health burden.
Survey instruments included a demographic questionnaire, life events questionnaire, childhood trauma questionnaire, trauma checklist, and PTSD symptom checklist. Respondents were asked to rate the presence or absence of posttraumatic stress symptoms in the past month based on their most traumatic experience.
Donbaek, Dagmar Feddern; Elklit, Ask
Gender is an important risk factor for both posttraumatic stress disorder (PTSD) and substance use disorders (SUD) in adolescents; however, little is known about the influence of gender when considering their common co-occurrence. This study examined whether problematic substance use, attachment...
Dirkzwager, J.E.; van der Velden, P.G.; Grievink, Linda; Yzermans, C.J.
Objective: To examine the relationship between posttraumatic stress disorder (PTSD) and self-reported as well as physicianrecorded physical health in a sample of survivors (n 896) of a man-made disaster, using a longitudinal design that included predisaster health data. Most studies on the
Dirkzwager, A.J.E.; Velden, P.G. van der; Grievink, L.; Yzermans, C.J.
OBJECTIVE: To examine the relationship between posttraumatic stress disorder (PTSD) and self-reported as well as physician-recorded physical health in a sample of survivors (n = 896) of a man-made disaster, using a longitudinal design that included predisaster health data. Most studies on the
Vries, G.J. de; Lok, A.; Mocking, R.; Assies, J.; Schene, A.H.; Olff, M.
BACKGROUND: Posttraumatic stress disorder (PTSD) is associated with increased morbidity and mortality through somatic conditions, particularly cardiovascular disease. The one-carbon metabolism in connection with the hypothalamic-pituitary-adrenal (HPA)-axis may be an important mediator of this
Turley, Matthew R.; Obrzut, John E.
Posttraumatic Stress Disorder (PTSD) can affect people of all ages but the literature is lacking on children and adolescents who experience PTSD. The consequences of this disorder extend beyond the basic symptoms by which it is defined. Neuroanatomically, the brains of children with PTSD have been found to be abnormally symmetrical in several…
Heru, Alison; Gagne, Gerard; Strong, David
Objective: The authors assessed medical student attitudes regarding mistreatment and symptoms of posttraumatic stress in those students who reported exposure to mistreatment. Methods: Third- and fourth-year medical students (N = 71) responded to questions from a vignette in which a student is mistreated and then described any mistreatment they had…
Women are disproportionately affected by the HIV epidemic and also carry a higher burden of early childhood trauma, other life traumas (e.g. rape and partner violence) and post-traumatic stress disorder (PTSD).1,2 Yet PTSD and other common psychiatric disorders (e.g. depression, alcohol abuse) are commonly ...
An increasing prevalence of borderline personality disorder (BPD) and posttraumatic stress disorder (PTSD) diagnoses among women illustrates problems and limitations of the medical model system. Article explores overlapping relationship between BPD and PTSD and critiques how both are viewed within the mental health community. Previous research is…
Lehavot, Keren; Katon, Jodie G; Chen, Jessica A; Fortney, John C; Simpson, Tracy L
Population-based data on the prevalence, correlates, and treatment utilization of post-traumatic stress disorder by gender and veteran status are limited. With changes in post-traumatic stress disorder diagnostic criteria in 2013, current information from a uniform data source is needed. This was a secondary analysis of the 2012-2013 National Epidemiologic Survey on Alcohol and Related Conditions-III, which consisted of in-person interviews that were conducted with a representative sample of U.S. adults. The Alcohol Use Disorder and Associated Disabilities Interview Schedule-DSM-5 Version was used to assess past-year and lifetime post-traumatic stress disorder among veterans (n=3,119) and civilians (n=32,982). Data were analyzed from January to March 2017. Adjusting for age and race/ethnicity, women veterans reported the highest rates of lifetime and past-year post-traumatic stress disorder (13.4%, 95% CI=8.8%, 17.9%, and 11.7%, 95% CI=7.1%, 16.4%) compared with women civilians (8.0%, 95% CI=7.4%, 8.6%, and 6.0%, 95% CI=5.5%, 6.6%); men veterans (7.7%, 95% CI=6.5%, 8.8%, and 6.7%, 95% CI=5.7%, 7.8%); and men civilians (3.4%, 95% CI=3.0%, 3.9%, and 2.6%, 95% CI=2.2%, 2.9%). Traumatic event exposure, correlates of lifetime post-traumatic stress disorder, and treatment seeking varied across subgroups. Men and women veterans were more likely than civilians to use a variety of treatment sources, with men civilians being least likely to seek treatment and men veterans exhibiting the longest delay in seeking treatment. Post-traumatic stress disorder is a common mental health disorder that varies by gender and veteran status. Women veterans' high rates of post-traumatic stress disorder highlight a critical target for prevention and intervention, whereas understanding treatment barriers for men veterans and civilians is necessary. Published by Elsevier Inc.
Teixeira, Paulo Josè Zimermann; Porto, Lucia; Kristensen, Christian Haag; Santos, Alvaro Huber; Menna-Barreto, Sergio Saldanha; Do Prado-Lima, Pedro AntÙnio Schmidt
Post-Traumatic Stress Disorder (PTSD) is a common psychological consequence of exposure to traumatic stressful life events. During COPD exacerbations dyspnea can be considered a near-death experience that may induce post-traumatic stress symptoms. The aim of this study was to evaluate the relationship between COPD exacerbations and PTSD- related symptoms. Thirty-three in-patients with COPD exacerbations were screened for the following: PTSS (Screen for Posttraumatic Stress Symptoms), anxiety (Beck Anxiety Inventory) and depression (Beck Depression Inventory). Patients had a median age of 72 years and 72.7% were female. Mean FEV1 and FVC were 0.8 ± 0.3 (37.7 ± 14.9% of predicted) and 1.7 ± 0.6 (60 ± 18.8% of predicted), respectively with a mean exacerbation of 2.9 episodes over the past year. Post-traumatic stress symptoms related to PTSD were found in 11 (33.3%) patients (SPTSS mean score 4.13 ± 2.54); moderate to severe depression in 16 (48.5%) (BDI mean score 21.2 ± 12.1) and moderate to severe anxiety in 23 (69.7%) (BAI mean score 23.5 ± 12.4). In a linear regression model, exacerbations significantly predicted post-traumatic stress symptoms scores: SPTSS scores increased 0.9 points with each exacerbation (p = 0.001). Significant correlations were detected between PTSD-related symptoms and anxiety (rs = 0.57; p = 0.001) and PTSD symptoms and depression (rs = 0.62; p = 0.0001). In a multivariable analysis model, two or more exacerbation episodes led to a near twofold increase in the prevalence ratio of post-traumatic stress symptoms related to PTSD(PR1.71; p = 0.015) specially those requiring hospitalization (PR 1.13; p = 0.030) CONCLUSION: PTSD symptoms increase as the patient's exacerbations increase. Two or more exacerbation episodes lead to a near twofold increase in the prevalence ratio of post-traumatic symptomatology. Overall, these findings suggest that psychological domains should be addressed along with respiratory function and exacerbations in
Nilsson, Doris; Nordenstam, Carin; Green, Sara; Wetterhall, Annika; Lundin, Tom; Svedin, Carl Göran
Rape is considered a stressful trauma and often with durable consequences. How the aftermath of rape is for young adolescents' girls considering acute stress is an overlooked field and remains to be studied. In this study, we wanted to investigate acute stress among adolescent victims of rape and the psychometric properties of the Acute Stress Checklist for Children (ASC-Kids). A clinical sample (n = 79) of raped girls, 13-17 years old who had turned to a special rape victim unit for treatment, answered the ASC-Kids. ASC-Kids was also given to a group of minor stressed, non-raped adolescents in the same age range (n = 154) together with the University of California at Los Angeles Post-traumatic Stress Disorder Reaction Index (UCLA PTSD RI), and the Sense of Coherence Scale 13 (SOC-13). The scores from the groups were compared and showed significant differences in mean values on all the diagnostic criteria of acute stress disorder. In the clinical group, 36.7% obtained full ASD criteria. ASC-Kids could discriminate well between groups. Cronbach's alpha was found to be excellent, and the correlation between the UCLA PTSD RI and ASC-Kids found to be good; both ASC-Kids and UCLA PTSD RI had a good and moderate negative correlation with SOC-13. Adolescent female rape victims were shown to have a very high level of acute stress, and the ASC-Kids was found to have sound psychometrics and can be a valuable screening instrument to support clinicians in their assessments of an indication of adolescents after potentially stressful events such as rape.
Transtornos de humor e de ansiedade comórbidos em vítimas de violência com transtorno do estresse pós-traumático Comorbid mood and anxiety disorders in victims of violence with posttraumatic stress disorder
Lucas C. Quarantini
Full Text Available OBJETIVO: Buscar estudos que avaliem a comorbidade entre transtorno de estresse pós-traumático e transtornos do humor, bem como entre transtorno de estresse pós-traumático e outros transtornos de ansiedade. MÉTODO: Revisamos a base de dados do Medline em busca de estudos publicados em inglês até abril de 2009, com as seguintes palavras-chave: "transtorno de estresse pós-traumático", "TEPT", "transtorno de humor", "transtorno depressivo maior", "depressão maior", "transtorno bipolar", "distimia", "transtorno de ansiedade", "transtorno de ansiedade generalizada", agorafobia", "transtorno obsessivo-compulsivo", "transtorno de pânico", "fobia social" e "comorbidade". RESULTADOS: Depressão maior é uma das condições comórbidas mais frequentes em indivíduos com transtorno de estresse pós-traumático, mas eles também apresentam transtorno bipolar e outros transtornos ansiosos. Essas comorbidades impõem um prejuízo clínico adicional e comprometem a qualidade de vida desses indivíduos. Comportamento suicida em pacientes com transtorno de estresse pós-traumático, com ou sem depressão maior comórbida, é também uma questão relevante, e sintomas depressivos mediam a gravidade da dor em sujeitos com transtorno de estresse pós-traumático e dor crônica. CONCLUSÃO: Os estudos disponíveis sugerem que pacientes com transtorno de estresse pós-traumático têm um risco maior de desenvolver transtornos afetivos e, por outro lado, transtornos afetivos pré-existentes aumentam a propensão ao transtorno de estresse pós-traumático após eventos traumáticos. Além disso, vulnerabilidades genéticas em comum podem ajudar a explicar esse padrão de comorbidades. No entanto, diante dos poucos estudos encontrados, mais trabalhos são necessários para avaliar adequadamente essas comorbidades e suas implicações clínicas e terapêuticas.OBJECTIVE: To review studies that have evaluated the comorbidity between posttraumatic stress
Farooqui, Mudassir; Quadri, Syed A; Suriya, Sajid S; Khan, Muhammad Adnan; Ovais, Muhammad; Sohail, Zohaib; Shoaib, Samra; Tohid, Hassaan; Hassan, Muhammad
Earthquakes are unpredictable and devastating natural disasters. They can cause massive destruction and loss of life and survivors may suffer psychological symptoms of severe intensity. Our goal in this article is to review studies published in the last 20 years to compile what is known about posttraumatic stress disorder (PTSD) occurring after earthquakes. The review also describes other psychiatric complications that can be associated with earthquakes, to provide readers with better overall understanding, and discusses several sociodemographic factors that can be associated with post-earthquake PTSD. A search for literature was conducted on major databases such as MEDLINE, PubMed, EMBASE, and PsycINFO and in neurology and psychiatry journals, and many other medical journals. Terms used for electronic searches included, but were not limited to, posttraumatic stress disorder (PTSD), posttraumatic symptoms, anxiety, depression, major depressive disorder, earthquake, and natural disaster. The relevant information was then utilized to determine the relationships between earthquakes and posttraumatic stress symptoms. It was found that PTSD is the most commonly occurring mental health condition among earthquake survivors. Major depressive disorder, generalized anxiety disorder, obsessive compulsive disorder, social phobia, and specific phobias were also listed. The PTSD prevalence rate varied widely. It was dependent on multiple risk factors in target populations and also on the interval of time that had elapsed between the exposure to the deadly incident and measurement. Females seemed to be the most widely-affected group, while elderly people and young children exhibit considerable psychosocial impact.
Full Text Available Abstract Objectives Earthquakes are unpredictable and devastating natural disasters. They can cause massive destruction and loss of life and survivors may suffer psychological symptoms of severe intensity. Our goal in this article is to review studies published in the last 20 years to compile what is known about posttraumatic stress disorder (PTSD occurring after earthquakes. The review also describes other psychiatric complications that can be associated with earthquakes, to provide readers with better overall understanding, and discusses several sociodemographic factors that can be associated with post-earthquake PTSD Method A search for literature was conducted on major databases such as MEDLINE, PubMed, EMBASE, and PsycINFO and in neurology and psychiatry journals, and many other medical journals. Terms used for electronic searches included, but were not limited to, posttraumatic stress disorder (PTSD, posttraumatic symptoms, anxiety, depression, major depressive disorder, earthquake, and natural disaster. The relevant information was then utilized to determine the relationships between earthquakes and posttraumatic stress symptoms. Results It was found that PTSD is the most commonly occurring mental health condition among earthquake survivors. Major depressive disorder, generalized anxiety disorder, obsessive compulsive disorder, social phobia, and specific phobias were also listed. Conclusion The PTSD prevalence rate varied widely. It was dependent on multiple risk factors in target populations and also on the interval of time that had elapsed between the exposure to the deadly incident and measurement. Females seemed to be the most widely-affected group, while elderly people and young children exhibit considerable psychosocial impact.
Chung, Man Cheung; Reed, Jacqueline
This study examined the incidence of PTSD and psychiatric co-morbidity among women who experienced stillbirth and investigated the relationship between locus of control, trauma characteristics of stillbirth, posttraumatic cognitions, PTSD and co-morbid psychiatric symptoms following stillbirth. Fifty women recorded information on stillbirth experiences, and completed the Posttraumatic Stress Diagnostic Scale, General Health Questionnaire-28, Edinburgh Post-natal Depression Scale, Rotter's Locus of Control Scale and the Posttraumatic Cognitions Inventory. 60, 28 and 12 % met the diagnostic criteria for probable full-PTSD, partial and no-PTSD respectively. Sixty-two percent and 54 % scored at or above the cutoff of the General Health Questionnaire-28 and postnatal depression respectively. Women who experienced stillbirth reported significantly more psychiatric co-morbid and post-natal depressive symptoms than the comparison group. Both groups were similar in locus of control. Women who experienced stillbirth reported negative cognitions about the self the most. After adjusting for postnatal depression, trauma characteristics were significantly correlated with Posttraumatic cognitions which, in turn, were significantly correlated with PTSD and psychiatric co-morbidity. Locus of control was not significantly correlated with psychological outcomes. Mediational analyses showed that negative cognitions about self mediated the relationship between trauma characteristics and psychiatric co-morbidity only. Women reported a high incidence of probable PTSD and co-morbid psychiatric symptoms following stillbirth. Stillbirth trauma characteristics influenced how they negatively perceived themselves. This then specifically influenced general psychological problems rather than PTSD symptoms.
Mealer, Meredith; Jones, Jacqueline
This article is a report of an analysis of the concept of posttraumatic stress disorder (PTSD) and its application to the nursing population. Nurses are at an increased risk for work-related stress resulting in retention issues and impaired functioning in work and home environment. The nursing discipline has been inconsistent with the concepts used to describe the distress and resultant discussions related to the comprehensive nature of the distress experienced, heavily focusing on existing medical language that emphasizes disorders and psychopathology. Walker and Avant's strategy for concept analysis was used in this analysis. A literature review for 1994-2011 was conducted for the following keywords: secondary traumatic stress, compassion fatigue, vicarious traumatization, posttraumatic stress disorder, and nurse. The concept of posttraumatic stress disorder in the nursing population is best described within the context of the Nurse as Wounded Healer theory. Essential attributes include intrusions, avoidance, and hyperarousal. The consequences include worldview changes, retention issues, sleep disruption, and social network disturbances. This concept analysis viewed through The Nurse as Wounded Healer lens, offers clarity to the concept of PTSD within the nursing population and identifies limitations to prior conceptualizations. © 2013 Wiley Periodicals, Inc.
Harvold, Mathea; MacLeod, Colin; Vaegter, Henrik Bjarke
OBJECTIVES: Posttraumatic stress disorder (PTSD) is common in chronic posttraumatic pain. Theoretical models suggest that attentional biases (AB) contribute to the development and maintenance of chronic pain and PTSD, however, the influence of AB on clinical and heat pain sensitivity in chronic...... posttraumatic pain patients is unknown. This study investigated AB for linguistic pain- and trauma-related stimuli, and clinical and thermal sensitivity in patients with chronic posttraumatic pain with and without PTSD. METHODS: Thirty-four patients with chronic posttraumatic cervical pain performed the visual...... (vigilance). Attentional avoidance of pain cues was associated with increased pain intensity and heat pain sensitivity (Pchronic posttraumatic pain. The causal contribution of attentional avoidance to pain...
Fichera, G P; Sartori, Samantha; Costa, G
Robbery at the place of work is one of the most common traumatic events in both developed and developing countries. Italy is one of the European countries with a medium-to-high prevalence and pharmacy and bank employees are particularly at risk. Research on the psychological effects on workers who are victims of robbery is scarce when compared with traditional trauma studies. To assess the association between workplace robbery, Post-traumatic Stress Disorder (PTSD), quality of life and work ability in a sample of Italian pharmacy workers. 136 pharmacy workers--90 robbery victims and 46 non-victims--were recruited from the Milan area. They completed a questionnaire including: socio-demographic characteristics, robbery history and description, a self-report version of the Clinician Administered PTSD Scale (CAPS-I), General Health Questionnaire (GHQ), Beck Depression Inventory (BDI), Work Ability Index (WAI), Short Form 36 Health Survey Questionnaire (SF-36). No differences were found between victims and non-victims for GHQ and BDL; WAI scores of victims were significantly lower than non-victims. Exposure to robberies was associated with lower WAI in a multivariate analysis; 10 victims reported PTSD and much lower WAI and SF-36, higher GHQ and BDI than non-PTSD victims. Workplace robbery has a mild but long-lasting effect on workers' ability to work. For a significant proportion of victims, robbery exposure is associated with the onset of PTSD, with increased risk for severe and long-lasting impairment of emotional well-being, quality of life and work ability. Early intervention programmes at the workplaces aimed at promoting a more rapid recovery after a traumatic event are needed.
Full Text Available AIM: High levels of anger and aggression in post-traumatic stress disorder lead to unfavorable social, legal, physical and economic results to family members and the other social layers as much as patients. In this study, it is aimed to investigate the relation between both alcohol-cigarette consumption ratios and anger levels, characteristics of aggressive behaviors and the judicial outcome in cases diagnosed post-traumatic stress disorder due to armed conflict. METHODS: 38 cases diagnosed as post-traumatic stress disorder were included to the study. Pre- and post-traumatic alcohol/cigarette consumption amounts and aggressive behaviors are determined. Impact of Events Scale (Revised (IES-R was used for evaluating post-traumatic stress disorder symptom patterns and severity, Buss Perry Aggression Questionnaire was used for measuring anger and aggression levels, and Taylor and #8217;s Violence Rating Scale was used for evaluating the judicial outcome of aggression. RESULTS: 23 of cases (60.6% were married with children, 13 of cases (34.25 were single and 2 of cases (5.2% were divorced.18 of cases (47.4% were graduate. IES-R total score was 66,9 +/- 12,7, Buss Perry total score was 111,3 +/- 20,5, and Taylor and #8217;s Violence Rate was 2,5 +/- 1,0. When the pre- and post-traumatic aggressive behaviors were compared; physical violence to the partner was increased more than ten times, Physical and verbal violence to social individuals were increased more than four and seven times, respectively. And also it is observed that inflicting damage to property was increased 17 times, reckless driving was increased 11 times, and self-mutilation was increased 5 times. Alcohol consumption was determined as 0 (0 - 126 g/day for pre-trauma cases and 16.5 (0 - 294 g/day for post-trauma cases. Cigarette smoking was determined as 5 (0 and #8211; 40 cigarette/day for pre-trauma cases and 30 (0 -60 cigarette/day for post-trauma cases. CONCLUSION: Post-traumatic
Elklit, Ask; Christiansen, Dorte M.
In recent years, a number of studies have investigated the prediction of posttraumatic stress disorder (PTSD) through the presence of acute stress disorder (ASD). The predictive power of ASD on PTSD was examined in a population of 148 female rape victims who visited a center for rape victims shortly after the rape or attempted rape. The PTSD…
Murphy, Dominic; Palmer, E; Lock, R; Busuttil, W
The aim of this paper was to examine levels of post-traumatic growth (PTG) in a sample of the UK veterans who had received treatment for post-traumatic stress disorder (PTSD). The study followed-up 149 UK veterans after they had completed standardised treatment for PTSD provided by Combat Stress. Data had previously been collected on a range of mental health outcomes before treatment, and then repeated 6 months after the end of treatment. For the current study, participants completed the post-traumatic growth inventory (PTGI) measure. Analysis was conducted to explore levels of PTG and whether there were any relationships between pretreatment and post-treatment ratings of mental health and PTG. The mean score on the PTGI was 32.6. Evidence of a treatment effect on levels of PTG was observed. There appeared to be a relationship between improvements in symptoms of PTSD and depression and higher levels of PTG. This study observed the presence of PTG following exposure to traumatic events within a sample of the UK veterans following their treatment for PTSD. PTG scores were moderately low in comparison to similar studies in the USA. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.
Full Text Available This longitudinal study aims to analyze predictors of posttraumatic stress symptoms (PTSS and posttraumatic growth (PTG among gender, age, objective factors of the disease and its treatment, family environment factors and negative emotionality. The sample consisted of 97 childhood cancer survivors (50 girls and 47 boys aged 11–25 years who were in remission 1.7 to seven years at T1 and four to 12.5 years at T2. Survivors completed a set of questionnaires including the Benefit Finding Scale for Children and the University of California at Los Angeles Posttraumatic Stress Disorder Index. Regression and correlation analyses were performed. The relation between PTSS and PTG was not proven. A higher level of PTSS (T2 was associated with higher levels of negative emotionality (T1. A higher level of PTG (T2 was connected to a higher level of warmth in parenting (T1, female gender and older age at assessment. Medical variables such as the severity of late effects and the time from treatment completion did not play a significant role in the prediction of PTSS and PTG. PTG and PTSS are more influenced by factors of parenting and emotional well-being of childhood cancer survivors than by objective medical data.
Lowe, Sarah R; Manove, Emily E; Rhodes, Jean E
The purpose of the study was to explore the relationship between posttraumatic stress (PTS) and posttraumatic growth (PTG) after Hurricane Katrina, and the role of demographics, predisaster psychological distress, hurricane-related stressors, and psychological resources (optimism and purpose) in predicting each. Participants were 334 low-income mothers (82.0% non-Hispanic Black) living in the New Orleans area prior to Hurricane Katrina, who completed surveys in the year prior to the hurricane (T1 [Time 1]) and 1 and 3 years thereafter (T2 and T3). Higher T2 and T3 PTS full-scale and symptom cluster subscales (Intrusion, Avoidance, and Hyperarousal) were significantly associated with higher T3 PTG, and participants who surpassed the clinical cutoff for probable posttraumatic stress disorder at both T2 and T3 had significantly higher PTG than those who never surpassed the clinical cutoff. Older and non-Hispanic Black participants, as well as those who experienced a greater number of hurricane-related stressors and bereavement, reported significantly greater T3 PTS and PTG. Participants with lower T2 optimism reported significantly greater T3 intrusive symptoms, whereas those with higher T1 and T2 purpose reported significantly greater T3 PTG. Based on the results, we suggest practices and policies with which to identify disaster survivors at greater risk for PTS, as well as longitudinal investigations of reciprocal and mediational relationships between psychological resources, PTS, and PTG. (c) 2013 APA, all rights reserved.
Sullivan, Tami P; Weiss, Nicole H
In the context of intimate partner violence (IPV), firearms may be used to threaten, coerce, and intimidate. Yet, what little research exists on firearms among IPV victims has focused almost exclusively on homicide or near homicide. Thus, the deleterious health consequences of firearms more broadly remain unknown. The goals of the current study were (1) to document the prevalence of firearm threat in a community sample of female IPV victims, and (2) to identify the extent to which threat with a firearm, independent of other forms of IPV, is related to women's posttraumatic stress disorder (PTSD) symptom severity. Participants were 298 women who had been a victim in a criminal domestic violence case with a male intimate partner (Mage = 36.39 years; 50.0% African American; 51.3% unemployed). Retrospective data on firearm threat, fear of firearm violence, other IPV victimization (i.e., physical, psychological, and sexual), and PTSD symptoms were collected during in-person individual interviews. Approximately one-quarter of the sample (24.2%) experienced threat with a firearm during the course of their relationship, and 12.5% were afraid that their partners would use a firearm against them in the 30 days prior to the study interview. Firearm threat and fear of firearm violence emerged as significant and unique predictors of PTSD symptom severity, controlling for age and physical, psychological, and sexual IPV victimization severity. The findings underscore firearm threat as a key factor for identifying and intervening with criminal justice involved women who experience IPV.
Mokma, Taylor R; Eshelman, Lee R; Messman-Moore, Terri L
Child sexual abuse and adult sexual assault have been linked to increased self-blame, posttraumatic stress symptoms, and alcohol use. The current study aims to examine (a) whether these constructs explain women's risk for later adult sexual assault and revictimization, (b) whether such factors differentially confer risk for specific types of adult sexual assault (i.e., substance-facilitated and forcible), and (c) if self-blame confers risk indirectly through other risk factors. Multiple types of self-blame, posttraumatic stress, and alcohol use were examined among 929 female college students as serial mediators of the relationship between child sexual abuse and adult sexual assault and as risk factors for sexual revictimization among child sexual abuse survivors. In the model predicting risk for substance-facilitated adult sexual assault, child sexual abuse indirectly predicted greater risk for substance-facilitated adult sexual assault mediated through two separate paths: global blame-to-posttraumatic-stress and global blame-to-alcohol use. In the model predicting risk for forcible adult sexual assault, child sexual abuse directly predicted greater risk for forcible adult sexual assault, and this relation was mediated by the global blame-to-posttraumatic-stress path. Among child sexual abuse survivors, child sexual abuse specific characterological and behavioral self-blame directly predicted greater risk for forcible and substance-facilitated revictimization, but the pathways were not mediated by posttraumatic stress or alcohol use. Results emphasize the importance of assessing different types of self-blame in predicting posttraumatic stress symptoms as well as examining risk for sexual victimization and revictimization. Findings did not support hypotheses that increased posttraumatic stress would predict increased alcohol use but did indicate that heightened self-blame is consistently associated with heightened posttraumatic stress and that heightened global self
Speed, N; Engdahl, B; Schwartz, J; Eberly, R
To estimate the relative contributions of trauma and premorbid disposition in the development and persistence of posttraumatic stress disorder (PTSD) symptoms, we conducted structured psychiatric interviews of 62 former World War II POWs. Half these men satisfied DSM-III criteria for PTSD in the year following repatriation. Eighteen (29%) continued to meet the criteria for PTSD 40 years later. Family history of mental illness and preexisting psychopathology were at best only weakly correlated with persistent PTSD symptoms. The strongest predictors of PTSD were proportion of body weight lost and the experience of torture during captivity. This study demonstrates that former POWs frequently develop posttraumatic stress disorder and that for one half of those who develop the symptoms, they persist for over 40 years. Familial risk factors and preexisting psychopathology are superseded by the overwhelming nature of the trauma. The persistence of the symptoms for many years is a reflection of the severity of the trauma.
Chung, Man Cheung; Jalal, Sabeena; Khan, Najib Ullah
This study investigated the extent of posttraumatic stress disorder (PTSD) and psychiatric comorbidity among the 2010 flood victims in Pakistan and its relationship with disaster exposure characteristics, cognitive distortions, and emotional suppression. One hundred and thirty-one (F = 89, M = 42) flood victims were assessed using the Posttraumatic Diagnostic Scale, the General Health Questionnaire-28, the Cognitive Distortion Scales, and the Courtauld Emotional Control Scale. The results showed that all victims met the diagnostic criteria for PTSD and scored above the cut-off for psychiatric caseness. Partial least squares modelling showed that disaster exposure characteristics were significantly correlated with PTSD and psychiatric comorbidity. Disaster exposure characteristics were also significantly associated with cognitive distortions which in turn were also significantly associated with PTSD and psychiatric comorbidity. Cognitive distortions were also correlated with emotional suppression which, however, was not associated with PTSD or psychiatric comorbidity. To conclude, the flood victims reported PTSD and psychiatric comorbid symptoms which were related to their subjective exposure to the flood. Such exposure led to the development of dysfunctional thinking patterns which in turn influenced distress symptoms.
Post-traumatic stress disorder (PTSD) and traumatic brain injury (TBI) often coexist because brain injuries are often sustained in traumatic experiences. This review outlines the significant overlap between PTSD and TBI by commencing with a critical outline of the overlapping symptoms and problems of differential diagnosis. The impact of TBI on PTSD is then described, with increasing evidence suggesting that mild TBI can increase risk for PTSD. Several explanations are offered for this enhanc...
Rewar S; Mirdha D; Rewar P
Post-traumatic stress disorder (PTSD) is a complex mental disorder with psychological and emotional components, caused by exposure to single or repeated extreme traumatic events found in war, terrorist attacks, natural or man-caused disasters, and by violent personal assaults and accidents. In recent years, armed conflicts in the Middle East have resulted in high rates of exposure to traumatic events. Despite the increasing demand of mental health care provision, ongoing violence limits conve...
Helle Svenningsen; Ingrid Egerod; Doris Christensen; Else Kirstine Tønnesen; Morten Frydenberg; Poul Videbech
Introduction. Long-term psychological consequences of critical illness are receiving more attention in recent years. The aim of our study was to assess the correlation of ICU-delirium and symptoms of posttraumatic stress disorder (PTSD) anxiety and depression after ICU-discharge in a Danish cohort. Methods. A prospective observational cohort study assessing the incidence of delirium in the ICU. Psychometrics were screened by validated tools in structured telephone interviews after 2 months (n...
Borsari, Brian; Read, Jennifer P.; Campbell, James F.
Research indicates that many college students report post-traumatic stress disorder (PTSD) or substance use disorder (SUD), yet there has been scant attention paid to the co-occurrence of these disorders in college students. This review examines the co-occurrence of PTSD and SUD in college students. Recommendations for counseling centers are provided regarding the assessment of this population, an overview of treatment issues, and three areas of clinical importance when working with this popu...
Background: Post-traumatic stress and exposure to early traumatic events are often characterised by negative self-cognitions and experiences of shame, guilt or blame. These symptoms are theoretically linked to the concept of self-compassion which is an important factor in affect regulation, and is predictive of mental wellbeing and psychological distress. Interventions aimed at increasing acceptance, non-judgement and self-compassion such as mindfulness may be useful in the tre...
Samuelson, Kristin W.; Metzler, Thomas J.; Rothlind, Johannes; Choucroun, Gerard; Neylan, Thomas C.; Lenoci, Maryanne; Henn-Haase, Clare; Michael W Weiner; Marmar, Charles R.
Studies have shown differences in neuropsychological functioning between groups with posttraumatic stress disorder (PTSD) and control participants. Because individuals with PTSD often have a history of comorbid alcohol abuse, the extent to which an alcohol confound is responsible for these differences remains a concern. The current study compares neuropsychological testing scores in 4 groups of veterans with and without PTSD (PTSD+] and PTSD–, respectively) and with and without a history of a...
and writing of this paper.Acknowledgements This work was supported by The U.S. Navy Bureau of Medicine and Surgery , Psychological Health and Traumatic...Fukunishi I. Relationship of cosmetic disfigurement to severity of posttraumatic stress disorder in burn injury or digital amputation. Psychother Psychosom...severely injured in motor vehicle accidents in Japan . Gen Hosp Psychiatry 2006;28:234–41. A.J. MacGregor et al. / Injury, Int. J. Care Injured 40
Wallin Lundell, Inger; Sundström Poromaa, Inger; Frans, Orjan; Helström, Lotti; Högberg, Ulf; Moby, Lena; Nyberg, Sigrid; Sydsjö, Gunilla; Georgsson Öhman, Susanne; Östlund, Ingrid; Skoog Svanberg, Agneta
To describe the prevalence and pattern of traumatic experiences, to assess the prevalence of posttraumatic stress disorder (PTSD) and posttraumatic stress symptoms (PTSS), to identify risk factors for PTSD and PTSS, and to analyse the association of PTSD and PTSS with concomitant anxiety and depressive symptoms in women requesting induced abortion. A Swedish multi-centre study of women requesting an induced abortion. The Screen Questionnaire - Posttraumatic Stress Disorder was used for research diagnoses of PTSD and PTSS. Anxiety and depressive symptoms were evaluated by the Hospital Anxiety and Depression Scale (HADS). Of the 1514 respondents, almost half reported traumatic experiences. Lifetime- and point prevalence of PTSD were 7% (95% confidence interval [CI]: 5.8-8.5) and 4% (95% CI: 3.1-5.2), respectively. The prevalence of PTSS was 23% (95% CI: 21.1-25.4). Women who reported symptoms of anxiety or depression when requesting abortion were more likely to have ongoing PTSD or PTSS. Also single-living women and smokers displayed higher rates of ongoing PTSD. Although PTSD is rare among women who request an induced abortion, a relatively high proportion suffers from PTSS. Abortion seeking women with trauma experiences and existing or preexisting mental disorders need more consideration and alertness when counselled for termination.
Şişmanlar Şahika G
Full Text Available Abstract Background Studies consistently found remarkable rates of posttraumatic stress symptoms (PTSS in children with chronic diseases. But, only one study had searched PTSS in children with diabetes, until now. So, the present study aimed to examine incidence rate and predictors of PTSS in children with type 1 diabetes. Method PTSS were evaluated by Child Posttraumatic Stress Reaction Index in fifty four children with diabetes (aged between 8–18 years. This assessment was based on hypoglycaemia as the potential traumatic event. Children were also introduced a brief questionnaire about demographic and disease related information. Some other information was obtained from families, medical stuff and records. Among 54 children, forty two had complete information. Hence, to evaluate possible predictive factors related with PTSS, multiple regression analysis was conducted for 42 children. Results 18.5% of children were reported PTSS at severe or very severe level, and 51.9% were reported PTSS at moderate level or above. Multiple regression analyses were shown that child PTSS were not significantly related with possible predictive factors other than number of hypoglycaemic attacks for the last month. Conclusion The study results support that posttraumatic stress symptoms are not rarely seen in paediatric patients with diabetes, and even if not severe, hypoglycaemic attacks may be perceived as traumatic by the children with diabetes. But, because of some limitations, the results should be carefully interpreted.
... Traumatic Stress Disorder Bipolar Mood Disorders Postpartum Psychosis Social Support Online Training Tools for Mom Frequently Asked Questions Screening Recommendations Useful Links Media Family International Father’s Mental Health Day Dads for World Maternal Mental Health Day ...
Skogstad, L; Heir, T; Hauff, E; Ekeberg, Ø
On 22 July 2011, Norway was struck by two terror attacks. Seventy-seven people were killed, and many injured. Rescue workers from five occupational groups and unaffiliated volunteers faced death and despair to assist victims. To investigate the level of, and associations between, demographic variables, exposure and work-related variables and post-traumatic stress symptoms (PTSS). A cross-sectional study of general and psychosocial health care personnel, police officers, firefighters, affiliated and unaffiliated volunteers were conducted ~10 months after the terror attacks. The respondents answered a self-reported questionnaire. Post-traumatic stress disorder (PTSD) Checklist - specific (PCL-S) assessed PTSS. There were 1790 participants; response rate was 61%. About 70% of the professional rescue workers had previous work experience with similar tasks or had participated in training or disaster drills. They assessed the rescue work as a success. Firefighters and unaffiliated volunteers reported more perceived threat compared with the other groups. Among the professional personnel, the prevalence of sub-threshold PTSD (PCL 35-49) was 2% and possible PTSD (PCL ≥ 50) 0.3%. The corresponding figures among the unaffiliated volunteers were 24% and 15%, respectively. In the multivariate analysis, female gender (β = 1.7), witnessing injured/dead (β = 2.0), perceived threat (β = 1.1), perceived obstruction in rescue work (β = 1.6), lower degree of previous training (β = -0. 9) and being unaffiliated volunteers (β = 8.3) were significantly associated with PTSS. In the aftermath of a terror attack, professional rescue workers appear to be largely protected from post-traumatic stress reactions, while unaffiliated volunteers seem to be at higher risk. © The Author 2016. Published by Oxford University Press on behalf of the Society of Occupational Medicine. All rights reserved. For Permissions, please email: firstname.lastname@example.org.
McNally, Richard J; Bryant, Richard A; Ehlers, Anke
In the wake of the terrorist attacks at the World Trade Center, more than 9,000 counselors went to New York City to offer aid to rescue workers, families, and direct victims of the violence of September 11, 2001. These mental health professionals assumed that many New Yorkers were at high risk for developing posttraumatic stress disorder (PTSD), and they hoped that their interventions would mitigate psychological distress and prevent the emergence of this syndrome. Typically developing in response to horrific, life-threatening events, such as combat, rape, and earthquakes, PTSD is characterized by reexperiencing symptoms (e.g., intrusive recollections of the trauma, nightmares), emotional numbing and avoidance of reminders of the trauma, and hyperarousal (e.g., exaggerated startle, difficulty sleeping). People vary widely in their vulnerability for developing PTSD in the wake of trauma. For example, higher cognitive ability and strong social support buffer people against PTSD, whereas a family or personal history of emotional disorder heightens risk, as does negative appraisal of one's stress reactions (e.g., as a sign of personal weakness) and dissociation during the trauma (e.g., feeling unreal or experiencing time slowing down). However, the vast majority of trauma survivors recover from initial posttrauma reactions without professional help. Accordingly, the efficacy of interventions designed to mitigate acute distress and prevent long-term psychopathology, such as PTSD, needs to be evaluated against the effects of natural recovery. The need for controlled evaluations of early interventions has only recently been widely acknowledged. Psychological debriefing-the most widely used method-has undergone increasing empirical scrutiny, and the results have been disappointing. Although the majority of debriefed survivors describe the experience as helpful, there is no convincing evidence that debriefing reduces the incidence of PTSD, and some controlled studies
PTSD, Social Support, Professional Military Education 16. SECURITY CLASSIFICATION OF: 17. LIMITATION OF ABSTRACT 18. NUMBER OF PAGES 19a. NAME...Support, Professional Military Education CLASSIFICATION: Unclassified The U.S. Army has been at war for more than nine years. Despite our...development comes from interacting with someone who explicitly understands the challenge. Communication , respect, and integration are fundamental at
Full Text Available Objectives: The aim of this study was to investigate prevalence and severity of post-traumatic stress disorder (PTSD symptoms in sexually abused children and in their parents.Materials and methods: Thirty-six sexually abused children and their parents formed the study group. Among children who presented to a first step health care office with various complaints 54 children without any sexual trauma history and with socio-demographical features similar to the study group have been included in the study with their parents as control group. PTSD symptoms of children and their parents were evaluated by post-traumatic stress disorder scales administered by clinicians.Results: Seventy-five percent of the children in the study group and 25 % of the children in the control group were diagnosed at least one psychiatric disorder. PTSD, depression, and anxiety disorder were the most frequent diagnoses in the study group. Frequency of PTSD diagnosis in children and their fathers was 64% and in their mothers 75%. In the control group it was 2% and 8% respectively.Conclusions: PTSD is prevalent in children victimized by sexual abuse and in their parents. In case of a sexual abuse, evaluating only the children does not seem to be sufficient; rather evaluating also their parents would be beneficial.
Swan, Sarah; Keen, Nadine; Reynolds, Nicola; Onwumere, Juliana
Individuals with severe mental health problems, such as psychosis, are consistently shown to have experienced high levels of past traumatic events. They are also at an increased risk of further traumatisation through victimization events such as crime and assault. The experience of psychosis itself and psychiatric hospitalization have also been recognized to be sufficiently traumatic to lead to the development of post-traumatic stress (PTS) symptoms. Rates of post-traumatic stress disorder (PTSD) are elevated in people with psychosis compared to the general population. The current guidance for the treatment of PTSD is informed by an evidence base predominately limited to populations without co-morbid psychiatric disorders. The systematic review therefore sought to present the current available literature on the use of psychological treatments targeting PTS symptoms in a population with a primary diagnosis of a psychotic disorder. The review aimed to investigate the effect of these interventions on PTS symptoms and also the effect on secondary domains such as psychotic symptoms, affect and functioning. Fifteen studies were identified reporting on cognitive behavior therapy, prolonged exposure, eye movement desensitisation and reprocessing and written emotional disclosure. The review provides preliminary support for the safe use of trauma-focused psychological interventions in groups of people with severe mental health problems. Overall, the interventions were found to be effective in reducing PTS symptoms. Results were mixed with regard to secondary effects on additional domains. Further research including studies employing sufficiently powered methodologically rigorous designs is indicated.
Toussaint, Loren L; Whipple, Mary O; Vincent, Ann
Symptoms of post-traumatic stress disorder are common in fibromyalgia patients. This study compared post-traumatic stress disorder symptoms in fibromyalgia patients and healthy controls and determined whether patient-control differences in post-traumatic stress disorder symptoms mediated differences in mental health. In all, 30 patients and 30 healthy controls completed questionnaires assessing symptoms of post-traumatic stress disorder and mental health. Fibromyalgia patients had greater symptoms of post-traumatic stress disorder and mental health than controls. Patient-control differences in mental health symptoms were fully or partially mediated by differences in post-traumatic stress disorder symptoms. Healthcare providers should understand the role of trauma as management of trauma symptoms may be one strategy for improving mental health.
Díaz-Marsá, M; Molina, R; Lozano, M C; Carrasco, J L
The postraumatic psychobiological stress disorder (PTSD) remains unclear although it is suggested that many systems are implicated. In this article, the PTSD biological aspects are reviewed, providing an exposition of main changes which are taking place in both the hypothalamic pituitary adrenal (HPA) and sympathetic nervous system (SNS). There are also some other mechanisms which are involved into human stress response such as thyroid function, neuropeptide Y, substance P and the opiod and glutamatergic system. Finally, we remark some changes which were found in neuroimaging techniques.
Solkoff, Norman; And Others
Vietnam combat veterans diagnosed as having Postraumatic Stress Disorder (PTSD) differed significantly in the intensity of their combat experiences and their perceptions of their homecoming experiences from controls who were also combat veterans. Neither early history nor immediate preservice factors differentiated the two groups. (Author/KS)
Tan, Liwen; Zhang, Li; Qi, Rongfeng; Lu, Guangming; Li, Lingjiang; Liu, Jun; Li, Weihui
This study compared the difference in brain structure in 12 mine disaster survivors with chronic post-traumatic stress disorder, 7 cases of improved post-traumatic stress disorder symptoms, and 14 controls who experienced the same mine disaster but did not suffer post-traumatic stress disorder, using the voxel-based morphometry method. The correlation between differences in brain structure and post-traumatic stress disorder symptoms was also investigated. Results showed that the gray matter volume was the highest in the trauma control group, followed by the symptoms-improved group, and the lowest in the chronic post-traumatic stress disorder group. Compared with the symptoms-improved group, the gray matter volume in the lingual gyrus of the right occipital lobe was reduced in the chronic post-traumatic stress disorder group. Compared with the trauma control group, the gray matter volume in the right middle occipital gyrus and left middle frontal gyrus was reduced in the symptoms-improved group. Compared with the trauma control group, the gray matter volume in the left superior parietal lobule and right superior frontal gyrus was reduced in the chronic post-traumatic stress disorder group. The gray matter volume in the left superior parietal lobule was significantly positively correlated with the State-Trait Anxiety Inventory subscale score in the symptoms-improved group and chronic post-traumatic stress disorder group (r = 0.477, P = 0.039). Our findings indicate that (1) chronic post-traumatic stress disorder patients have gray matter structural damage in the prefrontal lobe, occipital lobe, and parietal lobe, (2) after post-traumatic stress, the disorder symptoms are improved and gray matter structural damage is reduced, but cannot recover to the trauma-control level, and (3) the superior parietal lobule is possibly associated with chronic post-traumatic stress disorder. Post-traumatic stress disorder patients exhibit gray matter abnormalities.
Garland, Eric; Roberts-Lewis, Amelia
Exposure to traumatic events often results in severe distress which may elicit self-medication behaviors. Yet, some individuals exposed to trauma do not develop post-traumatic stress symptoms and comorbid addictive impulses. In the wake of traumatic events, psychological processes like thought suppression and mindfulness may modulate post-traumatic stress and craving for substances. We examined the differential roles of mindfulness and suppression in comorbid post-traumatic stress and craving...
C?mara, Rafael J A; Gander, Marie-Louise; Begr?, Stefan; von K?nel, Roland
Objective Violence, accidents and natural disasters are known to cause post-traumatic stress, which is typically accompanied by fear, suffering and impaired quality of life. Similar to chronic diseases, such events preoccupy the patient over longer periods. We hypothesised that post-traumatic stress could also be caused by Crohn's disease (CD), and that CD specific post-traumatic stress could be associated with an increased risk of disease exacerbation. Methods A cohort of CD patients was obs...
Kanagaratnam, Pushpa; Raundalen, Magne; Asbjørnsen, Arve E
This study focuses on the impact of present ideological commitment on posttraumatic stress symptoms in former child soldiers living in exile. Eighteen men and two women (aged 25-37), who had joined different Tamil armed groups in Sri Lanka between the ages of 13 and 17 years, participated. The Impact of Event Scale was used to measure posttraumatic symptoms. Qualitative methods were used to investigate the participants' ideological commitment. Participants reported being exposed to many potentially traumatizing events, and had high scores on the Impact of Event Scale. Twenty-five percent of the sample showed strong ideological commitment to the "cause". Ideological commitment at the present seemed to predict better mental health when exposure was less intense and overwhelming. Time had a negative impact on ideological commitment.
Gibbons, Susanne W; Barnett, Scott D; Hickling, Edward J
This study uses data from the 2005 Department of Defense Survey of Health-Related Behaviors Among Military Personnel to examine relationships between family stress and posttraumatic stress symptoms across 4 subgroups of Operation Iraqi Freedom-deployed (i.e., war in Iraq) or Operation Enduring Freedom-deployed (i.e., war in Afghanistan) active-duty military service members. Results suggest the following: (a) the greatest positive correlation of family stressors with posttraumatic stress symptoms was found within the military health care officer group, and (b) these military health care officers differed in family stressors mediating posttraumatic stress with divorce and financial problems accounting for significant and unique portions of the variance. Implications for care of service members and their families are discussed. Published by Elsevier Inc.
O'Mahony, Sean; Gerhart, James I; Grosse, Johanna; Abrams, Ira; Levy, Mitchell M
Vicarious exposure to trauma is ubiquitous in palliative medicine. Repeated exposure to trauma may contribute to compassion fatigue and posttraumatic stress disorder symptoms in medical and supportive care professionals such as physicians, nurses, and social workers. These symptoms may be intensified among medical and supportive care professionals who use avoidant or rigid coping strategies. This study aimed to provide an estimate of posttraumatic stress disorder symptoms in a sample of professionals who work in palliative care settings, and have already been enrolled in mindfulness-based communication training. Palliative care providers provided self-reported ratings of posttraumatic stress disorder symptoms, depression, and coping strategies using validated measures including the Acceptance and Action Questionnaire, Cognitive Fusion Questionnaire, and the Posttraumatic Stress Disorder Checklist-Civilian Version. A total of 21 professionals working with palliative care patients completed assessments prior to beginning mindfulness-based communication training. Posttraumatic stress disorder symptoms were prevalent in this sample of professionals; 42% indicated positive screens for significant posttraumatic stress disorder symptoms, and 33% indicated probable posttraumatic stress disorder diagnosis. Posttraumatic stress disorder symptoms may be common among professionals working in palliative medicine. Professionals prone to avoidant coping and those with more rigid negative thought processes may be at higher risk for posttraumatic stress disorder symptoms. © The Author(s) 2015.
Garland, Eric; Roberts-Lewis, Amelia
Exposure to traumatic events often results in severe distress which may elicit self-medication behaviors. Yet, some individuals exposed to trauma do not develop post-traumatic stress symptoms and comorbid addictive impulses. In the wake of traumatic events, psychological processes like thought suppression and mindfulness may modulate post-traumatic stress and craving for substances. We examined the differential roles of mindfulness and suppression in comorbid post-traumatic stress and craving in a sample of 125 persons with extensive trauma histories and psychiatric symptoms in residential treatment for substance dependence. Results indicated that thought suppression, rather than extent of trauma history, significantly predicted post-traumatic stress symptom severity while dispositional mindfulness significantly predicted both post-traumatic stress symptoms and craving. In multiple regression models, mindfulness and thought suppression combined explained nearly half of the variance in post-traumatic stress symptoms and one-quarter of the variance in substance craving. Moreover, multivariate path analysis indicated that prior traumatic experience was associated with greater thought suppression, which in turn was correlated with increased post-traumatic stress symptoms and drug craving, whereas dispositional mindfulness was associated with decreased suppression, post-traumatic stress, and craving. The maladaptive strategy of thought suppression appears to be linked with adverse psychological consequences of traumatic life events. In contrast, dispositional mindfulness appears to be a protective factor that buffers individuals from experiencing more severe post-traumatic stress symptoms and craving. PMID:22385734
Chapin, Mark G.
This study assessed the levels and types of violence exposure, levels of posttraumatic stress symptoms, and the relationship among exposure to violence, posttraumatic stress symptoms, and early discharge in U.S. Army recruits at Basic Combat Training (BCT). The study applied a modified ABCX model of family stress adaptation developed by McCubbin,…
Hansen, M.; Elklit, A.
Unfortunately, the number of bank robberies is increasing and little is known about the subsequent risk of posttraumatic stress disorder (PTSD). Several studies have investigated the prediction of PTSD through the presence of acute stress disorder (ASD). However, there have only been a few studie...
Full Text Available Ahmed Rady, Adel Elsheshai, Osama Elkholy, Heba Abou el WafaDepartment of Psychiatry, Alexandria University, Alexandria, EgyptAbstract: Post-traumatic stress disorder is a commonly overlooked psychiatric disorder due to the heterogeneity of symptoms that may simulate many other psychiatric disorders. Such heterogeneity of manifestations may be explained by the multifaceted nature of the different neurotransmitters, endocrinologic axis, and their genetic basis, that are implicated in the etiology. Although this disorder has been studied from many different perspectives, its etiology is still enigmatic. This minireview demonstrates, in brief, that different susceptibility genes are associated with post traumatic stress disorder.Keywords: trauma, post traumatic stress disorder, psychogenetic, stress response, neurobiology
Full Text Available Epidemiological studies report higher prevalence rates of stress-related disorders such as acute stress disorder and post-traumatic stress disorder (PTSD in women than in men following exposure to trauma. It is still not clear whether this greater prevalence in woman reflects a greater vulnerability to stress-related psychopathology. A number of individual and trauma-related characteristics have been hypothesized to contribute to these gender differences in physiological and psychological responses to trauma, differences in appraisal, interpretation or experience of threat, coping style or social support. In this context, the use of an animal model for PTSD to analyze some of these gender-related differences may be of particular utility. Animal models of PTSD offer the opportunity to distinguish between biological and socio-cultural factors, which so often enter the discussion about gender differences in PTSD prevalence.
Jieling Chen; Xiao Zhou; Min Zeng; Xinchun Wu
Objective The current longitudinal study aims to examine the bidirectional relationship between post-traumatic stress symptoms (PTSS) and post-traumatic growth (PTG). Method One hundred twenty-two adults in the most severely affected area were investigated by self-report questionnaires at 12 months and 18 months after the Wenchuan Earthquake occurred in China. Results The autoregressive cross-lagged structure equation analysis revealed that PTG at 12 months post-earthquake could negatively pr...
Full Text Available Abstract Background Although some previous studies have suggested that posttraumatic growth (PTG is comprised of several factors with different properties, few have examined both the association between PTG and posttraumatic stress disorder (PTSD and between PTG and resilience, focusing on each of the factors of PTG. This study aimed to examine the hypothesis that some factors of PTG, such as personal strength, relate to resilience, whereas other factors, such as appreciation of life, relate to PTSD symptoms among Japanese motor vehicle accident (MVA survivors. Methods This cross-sectional study was performed with 118 MVA survivors at 18 months post MVA. Data analyzed included self-reporting questionnaire scores on the Posttraumatic Growth Inventory (PTGI, the Impact of Event Scale- Revised (IES-R, and the Sense of Coherence (SOC scale, which is one of the most widely used scales for measuring resilience. Correlations between scores on the PTGI and IES-R, the PTGI and SOC scale, and the IES-R and SOC scale were established by calculating Spearman's correlation coefficients. Results PTGI was positively correlated with both SOC and PTSD symptoms, in spite of an inverse relationship between SOC and PTSD symptoms. Relating to others, new possibilities, and personal strength on the PTGI were correlated positively with SOC, and spiritual change and appreciation of life on the PTGI were positively correlated with PTSD symptoms. Conclusions Some factors of PTG were positively correlated with resilience, which can be regarded as an outcome of coping success, whereas other factors of PTG were positively correlated with PTSD symptoms, which can be regarded as signifying coping effort in the face of enduring distress. These findings contribute to our understanding of the psychological change experienced by MVA survivors, and to raising clinicians' awareness of the possibility that PTG represents both coping effort coexisting with distress and outcome of
Vernberg, E M; Silverman, W K; La Greca, A M; Prinstein, M J
The authors used an integrative conceptual model to examine the emergence of posttraumatic stress disorder (PTSD) symptoms in 568 elementary school-age children 3 months after Hurricane Andrew. The model included 4 primary factors: Exposure to Traumatic Events, Child Characteristics, Access to Social Support, and Children's Coping. Overall, 62% of the variance in children's self-reported PTSD symptoms was accounted for by the 4 primary factors, and each factor improved overall prediction of symptoms when entered in the analyses in the order specified by the conceptual model. The findings suggest that the conceptual model may be helpful to organize research and intervention efforts in the wake of natural disasters.
Full Text Available Post-traumatic stress disorder (PTSD is a debilitating condition that develops in a proportion of individuals following a traumatic event. Despite recent advances, ethical limitations associated with human research impede progress in understanding PTSD. Fortunately, much effort has focused on developing animal models to help study the pathophysiology of PTSD. Here, we provide an overview of animal PTSD models where a variety of stressors (physical, psychosocial, or psychogenic are used to examine the long-term effects of severe trauma. We emphasize models involving predator threat because they reproduce human individual differences in susceptibility to, and in the long-term consequences of, psychological trauma.
Elklit, Ask; Karstoft, Karen-Inge; Armour, Cherie
The associations between childhood abuse and subsequent criminality and posttraumatic stress disorder (PTSD) are well known. However, a major limitation of research related to childhood abuse and its effects is the focus on one particular type of abuse at the expense of others. Recent work has...... was constructed to include an oversampling of child protection cases. Building on a previous latent class analysis of four types of childhood maltreatment, three maltreatment typologies were used in the current analyses. A criminality scale was constructed based on seven types of criminal behavior. PTSD symptoms...
Goswami, Sonal; Rodríguez-Sierra, Olga; Cascardi, Michele; Paré, Denis
Post-traumatic stress disorder (PTSD) is a debilitating condition that develops in a proportion of individuals following a traumatic event. Despite recent advances, ethical limitations associated with human research impede progress in understanding PTSD. Fortunately, much effort has focused on developing animal models to help study the pathophysiology of PTSD. Here, we provide an overview of animal PTSD models where a variety of stressors (physical, psychosocial, or psychogenic) are used to examine the long-term effects of severe trauma. We emphasize models involving predator threat because they reproduce human individual differences in susceptibility to, and in the long-term consequences of, psychological trauma. PMID:23754973
adipose tissue, skin, and bone, cells of the aortic smooth muscle , and various regions of the brain. Because the ovaries shut off in postmenopausal... Bmj 2008;336:366-71. 54. Hoge CW, McGurk D, Thomas JL, Cox AL, Engel CC, Castro CA. Mild traumatic brain injury in U.S. Soldiers returning from...Suppl 17:23-8. 57. Kang HK, Natelson BH, Mahan CM, Lee KY, Murphy FM. Post-traumatic stress disorder and chronic fatigue syndrome-like illness among
Sperling, Wolfgang; Kreil, Sebastian Konstantin; Biermann, Teresa
The incidence of mental and somatic sequelae has been shown to be very high in the group of people damaged by the Holocaust. Within the context of internal research, 93 Holocaust survivors suffering from posttraumatic stress disorder have been examined. Patients suffered on average from 4.5 (standard deviation ± 1.8) somatic diagnoses as well as 1.8 (standard deviation ± 0.5) psychiatric diagnoses. A diagnosis of dementia was ascertained according to ICD-10 criteria in 14%. Vascular dementia (66%) dominated over Alzheimer's dementia (23%) and other subtypes (11%).
Garrison, C Z; Bryant, E S; Addy, C L; Spurrier, P G; Freedy, J R; Kilpatrick, D G
To examine rates and correlates of posttraumatic stress disorder (PTSD) in adolescents after Hurricane Andrew. A random-digit dialing sample of 158 Hispanic, 116 black, and 104 white adolescent-parent pairs were surveyed in high- and low-impact areas within Dade County, Florida, 6 months after Hurricane Andrew. Subjects completed a structured telephone interview focused on within-disaster experiences and emotional reaction, disaster-related losses, lifetime exposure to violent or traumatic events, recent stressful experiences, and psychiatric symptomatology. Approximately 3% of males (95% confidence interval 0.4 to 5.3) and 9% of females (95% confidence interval 4.6 to 13.7) met the criteria for PTSD. Rates were highest among blacks (8.3%, 95% confidence interval 2.3 to 14.2) and Hispanics (6.1%, 95% confidence interval 2.2 to 9.9) and increased with age (odds ratio of 1.34, 95% confidence interval 1.04 to 1.72) and the number of undesirable events reported (odds ratio of 1.38, 95% confidence interval 1.21 to 1.57). While only a relatively small percentage of adolescents reported symptoms consistent with a diagnosis of PTSD, most reported some posttraumatic symptoms. Postdisaster planning should recognize that common stressful events occurring after disasters may be more strongly associated with PTSD than magnitude of contact with the actual disaster.
Derluyn, Ilse; Broekaert, Eric; Schuyten, Gilberte; De Temmerman, Els
Worldwide, 300?000 children are currently used as child soldiers in armed conflicts. We interviewed 301 former child soldiers who had been abducted by the northern Ugandan rebellion movement Lord's Resistance Army. All the children were abducted at a young age (mean 12.9 years) and for a long time (mean 744 days). Almost all the children experienced several traumatic events (mean six events); 233 (77%) saw someone being killed, and 118 (39%) had to kill someone themselves. 71 children also filled in the impact of event scale--revised to assess their post-trauma stress reactions. 69 (97%) reported post-traumatic stress reactions of clinical importance. The death of a parent, especially of the mother, led to an important increase in score for avoidance symptoms (mother alive 16.4, mother not alive 21.6; p=0.04), with a high increase for girls (from 15.1 to 25.8), but almost no change for boys (from 17.7 to 17.4; p=0.02). Our findings shed light on the nature of severe trauma experienced by this group of children, and show a high rate of post-traumatic stress reactions.
Tigno, T A; Armonda, R A; Bell, R S; Severson, M A
Preliminary findings based on earlier retrospective studies of 229 wartime head injuries managed by the Walter Reed Army Medical Center (WRAMC)/National Naval Medical Center (NNMC) Neurosurgery Service during the period 2003-08 detected a threefold rise in Posttraumatic Stress Disorder (PTSD) manifestations (10.45%) among Traumatic Brain Injuries (TBI) having concomitant vestibulocochlear injuries compared to 3% for the TBI group without vestibulo-cochlear damage (VCD), prompting the authors to undertake a more focused study of the vestibulo-auditory pathway in explaining the development of posttraumatic stress disorder manifestations among the mostly Blast-exposed head-injured. The subsequent historical review of PTSD pathophysiology studies, the evidence for an expanded vestibular system and of a dominant vestibular system, the vascular vulnerability of the vestibular nerves in stress states as well as the period of cortical imprinting has led to the formation of a coherent hypotheses utilizing the vestibulocochlear pathway in understanding the development of PTSD manifestations. Neuroimaging and neurophysiologic tests to further validate the vestibulocochlear concept on the development of PTSD manifestations are proposed. Copyright © 2017 Elsevier Ltd. All rights reserved.
Nygaard, Egil; Hussain, Ajmal; Siqveland, Johan; Heir, Trond
Background Self-efficacy may be an important factor in individuals’ recovery from posttraumatic stress reactions after a natural disaster. However, few longitudinal studies have investigated whether self-efficacy predicts the course of posttraumatic recovery beyond lower initial levels of distress. The purpose of the present study was to investigate whether general self-efficacy is related to recovery from posttraumatic stress reactions from a longitudinal perspective. ...
Talbot, Lisa S; Maguen, Shira; Epel, Elissa S; Metzler, Thomas J; Neylan, Thomas C
The present study investigated the relationship between posttraumatic stress disorder (PTSD) and emotional eating in a sample of medically healthy and medication-free adults. Participants with PTSD (n = 44) and control participants free of lifetime psychiatric history (n = 49) completed a measure of emotional eating. Emotional eating is the tendency to eat or overeat in response to negative emotions. PTSD participants exhibited greater emotional eating than control participants (η(2) = .20) and emotional eating increased with higher PTSD symptom severity (R(2) = .11). Results supported the stress-eating-obesity model whereby emotional eating is a maladaptive response to stressors. Over time, this could lead to weight gain, particularly abdominal stores, and contribute to higher risk for comorbid medical disorders. Findings suggest the importance of future longitudinal research to understand whether emotional eating contributes to the high rates of obesity, diabetes, and heart disease in PTSD. Copyright © 2013 International Society for Traumatic Stress Studies.
Zalta, Alyson K; Gerhart, James; Hall, Brian J; Rajan, Kumar B; Vechiu, Catalina; Canetti, Daphna; Hobfoll, Stevan E
This study tested three alternative explanations for research indicating a positive, but heterogeneous relationship between self-reported posttraumatic growth (PTG) and posttraumatic stress symptoms (PSS): (a) the third-variable hypothesis that the relationship between PTG and PSS is a spurious one driven by positive relationships with resource loss, (b) the growth over time hypothesis that the relationship between PTG and PSS is initially a positive one, but becomes negative over time, and (c) the moderator hypothesis that resource loss moderates the relationship between PTG and PSS such that PTG is associated with lower levels of PSS as loss increases. A nationally representative sample (N = 1622) of Israelis was assessed at three time points during a period of ongoing violence. PTG, resource loss, and the interaction between PTG and loss were examined as lagged predictors of PSS to test the proposed hypotheses. Results were inconsistent with all three hypotheses, showing that PTG positively predicted subsequent PSS when accounting for main and interactive effects of loss. Our results suggest that self-reported PTG is a meaningful but counterintuitive predictor of poorer mental health following trauma.
Balducci, Cristian; Alfano, Vincenzo; Fraccaroli, Franco
This study investigates the relationships between the experience of mobbing at work and personality traits and symptom patterns as assessed by means of the revised version of the Minnesota Multiphasic Personality Inventory (MMPI-2). Participants were 107 workers who had contacted mental health services because they perceived themselves as victims of mobbing. In line with previous research, the results showed that the MMPI-2 mean profile was characterized by a neurotic component as evidenced by elevations of Scales 1, 2, and 3 and a paranoid component as indicated by elevation of Scale 6. Contrary to previous research, a pattern of positive and significant correlations was found between the frequency of exposure to mobbing behaviors and the MMPI-2 clinical, supplementary, and content scales, including the posttraumatic stress scale. Only about half the participants showed a severity of posttraumatic stress symptoms indicative of a posttraumatic stress disorder. The frequency of exposure to mobbing predicted suicidal ideation and behavior, with depression only partially mediating this relationship.
Chen, Long; Tan, Hongzhuan; Cofie, Reuben; Hu, Shimin; Li, Yan; Zhou, Jia; Yang, Tubao; Tang, Xuemin; Cui, Guanghui; Liu, Aizhong
To explore the prevalence and determinants of chronic post-traumatic stress disorder (PTSD) among flood victims. A cross-sectional survey was carried out in 2014 among individuals who had experienced the 1998 floods and had been diagnosed with PTSD in 1999 in Hunan, China. Cluster sampling was used to select subjects from the areas that had been surveyed in 1999. PTSD was diagnosed according to DSM-IV criteria, social support was measured according to a Social Support Rating Scale, coping style was measured according to a Simplified Coping Style Questionnaire, and personality was measured by use of the revised Eysenck Personality Questionnaire Short Scale for Chinese. Data were collected through face-to-face interviews by use of a structured questionnaire. Multivariate logistic regression analysis was used to reveal the determinants of chronic PTSD. A total of 123 subjects were interviewed, 17 of whom (14.4%) were diagnosed with chronic PTSD. Chronic PTSD was significantly associated with disaster stressors (odds ratio [OR]: 1.74; 95% confidence interval [CI]: 1.22-2.47), nervousness (OR: 1.09; 95% CI: 1.01-1.17), and social support (OR: 0.85; 95 CI%: 0.74-0.98). Chronic PTSD in flood victims is significantly associated with disaster stressors, nervousness, and social support. These factors may play important roles in identifying persons at high risk of chronic PTSD.
Weinberg, Michael; Gil, Sharon; Gilbar, Ora
The study examined the tendency to forgive (self, others, and situations) and coping strategies (problem-focused, emotion-focused, and avoidance) among terror attack victims as associated with posttraumatic stress disorder (PTSD) symptom severity. The sample included 108 terror victims who had been injured in terror attacks (mean age 46.23, standard deviation = 11.61; 58.3% male). Participants agreed to undergo assessments of their PTSD symptoms, coping strategies, and tendency to forgive. A nested structural equation model design showed that tendency to forgive is positively associated with problem-focused coping and negatively associated with avoidance coping. Additionally, tendency to forgive and problem-focused coping are associated with decreased PTSD symptom severity, whereas emotion-focused coping is associated with elevated PTSD symptom severity. Tendency to forgive and coping strategies are significantly associated with each other and with severity of PTSD symptoms among individuals injured in terror attacks. Theoretical and clinical implications of the findings are discussed. © 2013 Wiley Periodicals, Inc.
Cancer-related post-traumatic stress can occur any time from diagnosis to after treatment ends. Shock, fear, helplessness, or horror can be felt by cancer patients and lead to cancer-related post-traumatic stress. Learn about the causes and ways doctors can help manage these symptoms of distress in this expert-reviewed summary.
Cohen, Judith A.; Bukstein, Oscar; Walter, Heather; Benson, R. Scott; Chrisman, Allan; Farchione, Tiffany R.; Hamilton, John; Keable, Helene; Kinlan, Joan; Schoettle, Ulrich; Siegel, Matthew; Stock, Saundra; Medicus, Jennifer
This Practice Parameter reviews the evidence from research and clinical experience and highlights significant advances in the assessment and treatment of posttraumatic stress disorder since the previous Parameter was published in 1998. It highlights the importance of early identification of posttraumatic stress disorder, the importance of…
Karstoft, Karen-Inge; Andersen, Søren B.; Bertelsen, Mette
This study aimed to assess the diagnostic accuracy of the Posttraumatic Stress Disorder Checklist-Civilian Version (PCL-C; Weathers, Litz, Herman, Huska, & Keane, 1993) and to establish the most accurate cutoff for prevalence estimation of posttraumatic stress disorder (PTSD) in a representative...
Landolt, Markus A.; Ystrom, Eivind; Sennhauser, Felix H.; Gnehm, Hanspeter E.; Vollrath, Margarete E.
Background: Previous studies found notable rates of post-traumatic stress symptoms (PTSS) and post-traumatic stress disorder (PTSD) in pediatric patients and their parents and suggest a significant association between child and parent PTSS. However, little is known about mutual influences between child and parental PTSS over time. This study…
Becker, Stephen P.; Kerig, Patricia K.
Trauma and posttraumatic stress symptoms increasingly are recognized as risk factors for involvement with the juvenile justice system, and detained youth evidence higher rates of trauma exposure and posttraumatic stress disorder (PTSD) compared to their nondetained peers. Using a sample of 83 detained boys aged 12 to 17, we tested the hypothesis…
Swartzman, Samantha; Sani, Fabio; Munro, Alastair J
We compared social support with other potential psychosocial predictors of posttraumatic stress after cancer. These included family identification, or a sense of belonging to and commonality with family members, and family constraints, or the extent to which family members are closed, judgmental, or unreceptive in conversations about cancer. We also tested the hypothesis that family constraints mediate the relationship between family identification and cancer-related posttraumatic stress. We used a cross-sectional design. Surveys were collected from 205 colorectal cancer survivors in Tayside, Scotland. Both family identification and family constraints were stronger independent predictors of posttraumatic stress than social support. In multivariate analyses, social support was not a significant independent predictor of posttraumatic stress. In addition, there was a significant indirect effect of family identification on posttraumatic stress through family constraints. Numerous studies demonstrate a link between social support and posttraumatic stress. However, experiences within the family may be more important in predicting posttraumatic stress after cancer. Furthermore, a sense of belonging to and commonality with the family may reduce the extent to which cancer survivors experience constraints on conversations about cancer; this may, in turn, reduce posttraumatic stress. Copyright © 2016 John Wiley & Sons, Ltd.
Eekhout, Iris; Reijnen, Alieke; Vermetten, Eric; Geuze, Elbert
Background: Deployment can put soldiers at risk of developing post-traumatic stress symptoms. Despite several longitudinal studies, little is known about the timing of an increase in post-traumatic stress symptoms relative to pre-deployment. Longitudinal studies starting pre-deployment, in which
Full Text Available Abstract Background Psychiatric liaison services are rare in trauma units of various hospitals in Nigeria and other sub-Saharan African countries. The occurrence of road traffic accidents (RTAs resulting from low standard of road construction and inadequate maintenance have been on the increase in Nigeria. While the physical consequences of such RTAs are obvious, the psychological consequences are often not apparent. This study assessed the prevalence of posttraumatic stress disorder (PTSD among victims of RTAs and compared same with controls drawn from a population who have not experienced RTAs. It also assessed the associated socio-demographic variables. Method Study population consisted of one hundred and fifty RTA victims and two different control groups drawn from the population consisting of staffs of Federal Neuropsychiatric Hospital, Enugu, Nigeria and that of National Orthopedic Hospital, Enugu, Nigeria, 150 people in each control group were matched for age and sex with the RTA victims and they were interviewed with PTSD module of Mini International Neuropsychiatric Interview (MINI and their socio-demographic variables obtained with socio-demographic questionnaire. Results The prevalence of PTSD among RTA victims and the two control groups were 26.7%, 8.0% and 8.7% respectively. The difference in prevalence was statistically significant with RTA victims more likely to experience PTSD compared to the two control groups (X2 = 27.23, df = 2, p = 0.001. Gender influenced the prevalence of PTSD among victims of RTAs and the controls, with females more likely to experience PTSD when compared to the males. Among victims of RTAs, being gainfully employed prior to the accidents increased the likelihood of developing PTSD and this was statistically significant (X2 = 20.09, df = 1, p = 0.000. Conclusions There is urgent need to pay more attention to developing consultation-liaison psychiatry services in trauma units of Nigerian hospitals
Iteke, Obiora; Bakare, Muideen O; Agomoh, Ahamefule O; Uwakwe, Richard; Onwukwe, Jojo U
Psychiatric liaison services are rare in trauma units of various hospitals in Nigeria and other sub-Saharan African countries. The occurrence of road traffic accidents (RTAs) resulting from low standard of road construction and inadequate maintenance have been on the increase in Nigeria. While the physical consequences of such RTAs are obvious, the psychological consequences are often not apparent. This study assessed the prevalence of posttraumatic stress disorder (PTSD) among victims of RTAs and compared same with controls drawn from a population who have not experienced RTAs. It also assessed the associated socio-demographic variables. Study population consisted of one hundred and fifty RTA victims and two different control groups drawn from the population consisting of staffs of Federal Neuropsychiatric Hospital, Enugu, Nigeria and that of National Orthopedic Hospital, Enugu, Nigeria, 150 people in each control group were matched for age and sex with the RTA victims and they were interviewed with PTSD module of Mini International Neuropsychiatric Interview (MINI) and their socio-demographic variables obtained with socio-demographic questionnaire. The prevalence of PTSD among RTA victims and the two control groups were 26.7%, 8.0% and 8.7% respectively. The difference in prevalence was statistically significant with RTA victims more likely to experience PTSD compared to the two control groups (X² = 27.23, df = 2, p = 0.001). Gender influenced the prevalence of PTSD among victims of RTAs and the controls, with females more likely to experience PTSD when compared to the males. Among victims of RTAs, being gainfully employed prior to the accidents increased the likelihood of developing PTSD and this was statistically significant (X² = 20.09, df = 1, p = 0.000). There is urgent need to pay more attention to developing consultation-liaison psychiatry services in trauma units of Nigerian hospitals, including orthopedic hospitals located in different geographical
Speck, V; Schlereth, T; Birklein, F; Maihöfner, C
Although specific psychological disorders in complex regional pain syndrome (CRPS) have not been identified, studies suggest that CRPS patients may have increased rates of traumatic life events. Because these events do not always lead to apparent psychological symptoms, we systematically screened CRPS patients for posttraumatic stress disorder (PTSD) to determine if PTSD could be a risk factor for CRPS. Consecutive CRPS patients referred to two university hospital centres (University of Erlangen, UMC Mainz) between December 2011 and April 2013 were prospectively examined using a diagnostic PTSD instrument (Post-traumatic Stress Diagnostic Scale (PDS). We also tested maladaptive coping strategies (brief-COPE inventory) and the PDS severity score as predictors for CRPS. Patients with non-CRPS extremity pain and healthy individuals were used as control groups. We collected data from 152 patients with CRPS, 55 control patients and 55 age- and sex-matched healthy individuals. Fifty-eight CRPS patients (38%), six non-CRPS pain patients (10%) and two healthy individuals (4%) met diagnostic criteria for PTSD. Initial PTSD symptom onset was prior to CRPS in 50 CRPS patients (86%) and during the course of CRPS in eight patients. Results of a logistic regression revealed that the PTSD severity score was associated with CRPS (p CRPS than it is in the general population. Research has not yet provided support for specific psychological predictors for CRPS. © 2016 European Pain Federation - EFIC®.
Barak, Yoram; Szor, Henry
Despite the fact that 50 years have passed since the Nazi regime and the Holocaust the psychic sequelae are far from being overcome. The majority of Holocaust survivors and World War II veterans still list their experiences as the “most significant stressors” of their lives. The literature provides ample evidence that posttraumatic stress disorder among survivors persists into old age. However, there is still a need to define the differences in frequency, clinical presentation, severity, and comorbid conditions among aging Holocaust survivors. Age at the time of trauma, cumulative lifetime stress, and physical illness are reported to have a positive association with more severe posttraumatic symptomatology. The presence of comorbid Axis i psychiatric disorders (Diagnostic and Statistical Manual [DSIVI]), has been the focus of research by our group, demonstrating that their interaction with earlier trauma leads to a course of chronic, debilitating disease. Despite reactivation of traumatic symptoms during aging and continuous mental suffering, the majority of Holocaust survivors show good instrumental coping and preserved functioning. PMID:22033740
Landis-Shack, Nora; Heinz, Adrienne J; Bonn-Miller, Marcel O
Music therapy has been employed as a therapeutic intervention to facilitate healing across a variety of clinical populations. There is theoretical and empirical evidence to suggest that individuals with trauma exposure and Posttraumatic Stress Disorder (PTSD), a condition characterized by enduring symptoms of distressing memory intrusions, avoidance, emotional disturbance, and hyperarousal, may derive benefits from music therapy. The current narrative review describes the practice of music therapy and presents a theoretically-informed assessment and model of music therapy as a tool for addressing symptoms of PTSD. The review also presents key empirical studies that support the theoretical assessment. Social, cognitive, and neurobiological mechanisms (e.g., community building, emotion regulation, increased pleasure, anxiety reduction) that promote music therapy's efficacy as an adjunctive treatment for individuals with posttraumatic stress are discussed. It is concluded that music therapy may be a useful therapeutic tool to reduce symptoms and improve functioning among individuals with trauma exposure and PTSD, though more rigorous empirical study is required. In addition, music therapy may help foster resilience and engage individuals who struggle with stigma associated with seeking professional help. Practical recommendations for incorporating music therapy into clinical practice are offered along with several suggestions for future research.
Bennett, Hazel; Wells, Adrian
The present study aimed to assess the relative contribution of memory disorganization and beliefs about trauma memory in the prediction of posttraumatic stress symptoms. A sample of 95 student nurses and midwives narrated their memory of the most distressing placement related event they had experienced. Several questionnaires were administered, including the Beliefs about Memory Questionnaire (BAMQ), which was devised for the study. Pearson's correlations, hierarchical analyses and mediation analyses were performed on the data. The reliability and validity of the BAMQ gained preliminary support. Beliefs about the trauma memory, but not memory disorganization within the trauma narrative, predicted a significant proportion of the variance in posttraumatic stress symptoms after control variables were accounted for. Consistent with the metacognitive model of PTSD, the use of rumination mediated the relationship between beliefs about the trauma memory and PTSD symptoms. The findings provide preliminary support for the role of meta-memory in the maintenance of PTSD symptoms and question the importance of memory disorganization. (c) 2010 Elsevier Ltd. All rights reserved.
de Kleine, Rianne A; Hendriks, Lotte; Becker, Eni S; Broekman, Theo G; van Minnen, Agnes
Exposure therapy has proven efficacy in the treatment of posttraumatic stress disorder (PTSD). Emotional processing theory proposes that fear habituation is a central mechanism in symptom reduction, but the empirical evidence supporting this is mixed. Recently it has been proposed that violation of harm expectancies is a crucial mechanism of action in exposure therapy. But to date, changes in harm expectancies have not been examined during exposure therapy in PTSD. The goal of the current study was to examine harm expectancy violation as mechanism of change in exposure therapy for posttraumatic stress disorder (PTSD). Patients (N=50, 44 female) with a primary diagnosis of chronic PTSD received intensive exposure therapy. Harm expectancies, harm experiences and subjective units of distress (SUDs) were assessed at each imaginal exposure session, and PTSD symptoms were assessed pre- and posttreatment with the Clinician Administered PTSD Scale (CAPS). Results showed that harm expectancies were violated within and strongly declined in-between exposure therapy sessions. However, expectancy violation was not related to PTSD symptom change. Fear habituation measures were moderately related to PTSD symptom reductions. In line with theory, exposure therapy promotes expectancy violation in PTSD patients, but this is not related to exposure therapy outcome. More work is warranted to investigate mechanisms of change during exposure therapy in PTSD. Copyright © 2017 Elsevier Ltd. All rights reserved.
Landis-Shack, Nora; Heinz, Adrienne J.; Bonn-Miller, Marcel O.
Music therapy has been employed as a therapeutic intervention to facilitate healing across a variety of clinical populations. There is theoretical and empirical evidence to suggest that individuals with trauma exposure and Posttraumatic Stress Disorder (PTSD), a condition characterized by enduring symptoms of distressing memory intrusions, avoidance, emotional disturbance, and hyperarousal, may derive benefits from music therapy. The current narrative review describes the practice of music therapy and presents a theoretically-informed assessment and model of music therapy as a tool for addressing symptoms of PTSD. The review also presents key empirical studies that support the theoretical assessment. Social, cognitive, and neurobiological mechanisms (e.g., community building, emotion regulation, increased pleasure, anxiety reduction) that promote music therapy’s efficacy as an adjunctive treatment for individuals with posttraumatic stress are discussed. It is concluded that music therapy may be a useful therapeutic tool to reduce symptoms and improve functioning among individuals with trauma exposure and PTSD, though more rigorous empirical study is required. In addition, music therapy may help foster resilience and engage individuals who struggle with stigma associated with seeking professional help. Practical recommendations for incorporating music therapy into clinical practice are offered along with several suggestions for future research. PMID:29290641
Seth D Norrholm
Full Text Available Seth D Norrholm1,2, Tanja Jovanovic21Atlanta VA Medical Center, Mental Health Service Line, Decatur, GA, USA; 2Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USAAbstract: According to the Diagnostic and Statistical Manual of Mental Disorders, 4th edition, posttraumatic stress disorder (PTSD is characterized by three major symptom clusters following an event that elicited fear, helplessness, or horror. This review will examine each symptom cluster of PTSD separately, giving case study examples of patients who exhibit a preponderance of a given symptom domain. We use a translational approach in describing the underlying neurobiology that is relevant to particular symptoms and treatment options, thus showing how clinical practice can benefit from current research. By focusing on symptom clusters, we provide a more specific view of individual patient’s clinical presentations, in order to better address treatment needs. Finally, the review will also address potential genetic approaches to treatment as another form of individualized treatment.Keywords: psychophysiology, pharmacotherapy, exposure therapy, pharmacogenetics; posttraumatic stress disorder, symptom clusters
Arigo, Danielle; Juth, Vanessa; Trief, Paula; Wallston, Kenneth; Ulbrecht, Jan; Smyth, Joshua M
This study examined reported post-traumatic stress disorder symptoms in adults with poorly controlled type 2 diabetes who had no history of psychiatric diagnosis or treatment ( n = 184, MHbA1c = 9.13%, standard deviation = 1.68). Participants reported moderate to severe intensity of post-traumatic stress disorder symptoms ( M = 19.17, SD = 17.58). Together, depressive and post-traumatic stress disorder symptoms accounted for 10-40 percent of the variance in type 2 diabetes outcomes; post-traumatic stress disorder symptoms were associated with elevated diabetes distress and more frequent exercise and self-blood glucose testing (unique R2 ~ 3%). Post-traumatic stress disorder symptoms may be overlooked in type 2 diabetes among patients without formal psychiatric diagnoses, and warrant increased attention.
Nygaard, Egil; Hussain, Ajmal; Siqveland, Johan; Heir, Trond
Self-efficacy may be an important factor in individuals' recovery from posttraumatic stress reactions after a natural disaster. However, few longitudinal studies have investigated whether self-efficacy predicts the course of posttraumatic recovery beyond lower initial levels of distress. The purpose of the present study was to investigate whether general self-efficacy is related to recovery from posttraumatic stress reactions from a longitudinal perspective. A total of 617 Norwegians exposed to the 2004 Southeast Asian tsunami completed self-report questionnaires measuring their level of disaster exposure and general self-efficacy at 6 months and posttraumatic stress reactions 6 months and 2 years post-disaster. Predictors of changes in posttraumatic stress reactions were analyzed with multivariate mixed effects models. Self-efficacy at 6 months post-disaster was unrelated to trauma exposure and inversely related to posttraumatic stress reactions at 6 months and 2 years post-disaster. However, self-efficacy was not related to recovery from posttraumatic stress reactions between 6 months and 2 years post-disaster. In conclusion, general self-efficacy is related to lower levels of posttraumatic stress reactions in the first months after a disaster but does not appear to be related to improved recovery rates over the longer term.
Dirkzwager, A.J.E.; Bramsen, I.; Ploeg, H.M. van der
This study examined both cross-sectionally and longitudinally the relationship between social support, coping strategies, additional stressful life events, and symptoms of posttraumatic stress disorder (PTSD) among Dutch former peacekeeping soldiers. Two groups of peacekeepers were investigated: 311
CHRISTODOULOU-SMITH, JOAN; GOLD, JEFFREY I.; ROMERO, ROBERTO; GOODWIN, THOMAS M.; MACGIBBON, KIMBER W.; MULLIN, PATRICK M.; FEJZO, MARLENA S.
Objective Hyperemesis gravidarum (HG) can be accompanied by severe physical and emotional distress. Most studies have focused on the physical and psychological stress associated with this condition during the affected pregnancy. This study explores posttraumatic stress symptoms (PTSS) and negative life outcomes following HG pregnancies. Methods A total of 610 women (HG = 377 and control = 233) were recruited and completed an online survey. χ-square analyses were used to compare the HG and control groups on various life outcome variables. Results Eighteen percent of women with HG reported full criteria PTSS (n = 68). Negative life outcomes regarding financial and marital status, career, as well as psychological and physical well-being differed significantly for the HG groups compared to the control group (0.001 pregnancies and is associated with negative life outcomes including inability to breastfeed, marital problems, financial problems, and inability of self care. PMID:21635201
Ratzer, Mette; Brink, Ole; Knudsen, Linda
Aims: This study aimed to estimate the prevalence of severe Posttraumatic Stress Disorder (PTSD) symptoms and to identify factors associated with PTSD in survivors of intensive care unit (ICU) treatment following traumatic injury. Methods: Fifty-two patients who were admitted to an ICU through...... the emergency ward following traumatic injury were prospectively followed. Information on injury severity and ICU treatment were obtained through medical records. Demographic information and measures of acute stress symptoms, experienced social support, coping style, sense of coherence (SOC) and locus...... of control were assessed within one-month post-accident (T1). At the six months follow-up (T2), PTSD was assessed with the Harvard Trauma Questionnaire (HTQ). Results: In the six months follow-up, 10 respondents (19.2%) had HTQ total scores reaching a level suggestive of PTSD (N = 52), and 11 respondents (21...
The aims of this study were to compare the level of posttraumatic stress disorder between adults with and without congenital heart disease, and to examine the correlates of posttraumatic stress disorder (e.g., sociodemographics). Cross-sectional. Two university-affiliated heart hospitals in Tehran, Iran. A sample of 347 adults with congenital heart disease aged 18-64 years (52% women), and 353 adults without congenital heart disease matched by sex and age (±2 years) was recruited. The PTSD Scale: Self-report version was used to assess the diagnosis and severity of posttraumatic stress disorder. Hierarchical multivariate logistic regression analyses were performed to explore correlates of likely posttraumatic stress disorder diagnosis among each group of participants. The posttraumatic stress disorder in the patients was comparable to those of the control group, except for increased arousal (P = .027) which was scored higher among the patients. Over 52% of adults with congenital heart disease met the criteria for a likely posttraumatic stress disorder diagnosis compared with 48% of adults without congenital heart disease. The regression analyses among patients revealed that elevated depressive symptoms (OR = 1.27) and a positive history of cardiac surgery (OR = 2.02) were significantly associated with posttraumatic stress disorder. The model could explain 29% of the variance in posttraumatic stress disorder. The high and comparable prevalence of posttraumatic stress disorder among patients and nonpatients highlight the significance of the context in which adults with congenital heart disease may face other/additional stressors than disease-related ones, an issue that clinicians need also take into account. Furthermore, the association of posttraumatic stress disorder with elevated depressive symptoms warrant a comprehensive psychological assessment and management of adults with congenital heart disease, in particular among those with a history of
Möller, Anna; Söndergaard, Hans Peter; Helström, Lotti
Active resistance is considered to be the 'normal' reaction during rape. However, studies have indicated that similar to animals, humans exposed to extreme threat may react with a state of involuntary, temporary motor inhibition known as tonic immobility. The aim of the present study was to assess the occurrence of tonic immobility during rape and subsequent post-traumatic stress disorder and severe depression. Tonic immobility at the time of the assault was assessed using the Tonic Immobility Scale in 298 women who had visited the Emergency clinic for raped women within 1 month of a sexual assault. Information about the assault and the victim characteristics were taken from the structured clinical data files. After 6 months, 189 women were assessed regarding the development of post-traumatic stress disorder and depression. Of the 298 women, 70% reported significant tonic immobility and 48% reported extreme tonic immobility during the assault. Tonic immobility was associated with the development of post-traumatic stress disorder (OR 2.75; 95% CI 1.50-5.03, p = 0.001) and severe depression (OR 3.42; 95% CI 1.51-7.72, p = 0.003) at 6 months. Further, previous trauma history (OR 2.36; 95% CI 1.48-3.77, p depression. Knowledge of this reaction in sexual assault victims is important in legal matters and for healthcare follow up. © 2017 Nordic Federation of Societies of Obstetrics and Gynecology.
Engelhard, I.M.; van den Hout, M.; Kindt, M.
The personality trait of Neuroticism has been repeatedly associated with symptoms of post-traumatic stress disorder (PTSD). However, the nature of this relationship is unclear. There are at least two possible interpretations: neuroticism might be a risk factor for PTSD symptoms, or, alternatively,
Chen, Jieling; Zhou, Xiao; Zeng, Min; Wu, Xinchun
The current longitudinal study aims to examine the bidirectional relationship between post-traumatic stress symptoms (PTSS) and post-traumatic growth (PTG). One hundred twenty-two adults in the most severely affected area were investigated by self-report questionnaires at 12 months and 18 months after the Wenchuan Earthquake occurred in China. The autoregressive cross-lagged structure equation analysis revealed that PTG at 12 months post-earthquake could negatively predict PTSS at 18 months post-earthquake above and beyond PTSS stability, whereas PTSS at 12 months post-earthquake could not significantly predict subsequent PTG. Moreover, PTG at 12 months post-earthquake could predict fewer subsequent intrusions, numbing and hyper-arousal symptoms but not avoidance symptoms. Growth can play a role in reducing long-term post-traumatic stress symptoms, and the implication of a positive perspective in post-trauma circumstance is discussed.
Full Text Available Abstract Background There is limited research on the relevance of family structures to the development and maintenance of posttraumatic stress following disasters. We longitudinally studied the effects of marital and parental statuses on posttraumatic stress reactions after the 2004 Southeast Asian tsunami and whether persons in the same households had more shared stress reactions than others. Method The study included a tourist population of 641 Norwegian adult citizens, many of them from families with children. We measured posttraumatic stress symptoms with the Impact of Event Scale-Revised at 6 months and 2 years post-disaster. Analyses included multilevel methods with mixed effects models. Results Results showed that neither marital nor parental status was significantly related to posttraumatic stress. At both assessments, adults living in the same household reported levels of posttraumatic stress that were more similar to one another than adults who were not living together. Between households, disaster experiences were closely related to the variance in posttraumatic stress symptom levels at both assessments. Within households, however, disaster experiences were less related to the variance in symptom level at 2 years than at 6 months. Conclusions These results indicate that adult household members may influence one another's posttraumatic stress reactions as well as their interpretations of the disaster experiences over time. Our findings suggest that multilevel methods may provide important information about family processes after disasters.
Almli, Lynn M.; Fani, Negar; Smith, Alicia K.; Ressler, Kerry J.
Post-traumatic stress disorder (PTSD) is increasingly recognized as both a disorder of enormous mental health and societal burden, but also as an anxiety disorder that may be particularly understandable from a scientific perspective. Specifically, PTSD can be conceptualized as a disorder of fear and stress dysregulation, and the neural circuitry underlying these pathways in both animals and humans are becoming increasingly well understood. Furthermore, PTSD is the only disorder in psychiatry in which the initiating factor, the trauma exposure, can be identified. Thus, the pathophysiology of the fear and stress response underlying PTSD can be examined and potentially interrupted. Twin studies have shown that the development of PTSD following a trauma is heritable, and that genetic risk factors may account for up to 30–40% of this heritability. A current goal is to understand the gene pathways that are associated with PTSD, and how those genes act on the fear/stress circuitry to mediate risk vs. resilience for PTSD. This review will examine gene pathways that have recently been analysed, primarily through candidate gene studies (including neuroimaging studies of candidate genes), in addition to genome-wide associations and the epigenetic regulation of PTSD. Future and on-going studies are utilizing larger and collaborative cohorts to identify novel gene candidates through genome-wide association and other powerful genomic approaches. Identification of PTSD biological pathways strengthens the hope of progress in the mechanistic understanding of a model psychiatric disorder and allows for the development of targeted treatments and interventions. PMID:24103155
Gupta, Madhulika A; Jarosz, Patricia; Gupta, Aditya K
Dermatologic symptoms can be associated with posttraumatic stress disorder (PTSD) in several situations: (1) as features of some core PTSD symptoms, such as intrusion symptoms manifesting as cutaneous sensory flashbacks, as autonomic arousal manifesting as night sweats and idiopathic urticaria, and as dissociation manifesting as numbness and dermatitis artefacta; (2) the cutaneous psychosomatic effects of emotional and physical neglect and sexual abuse (eg, infantile eczema, cutaneous self-injury, and body-focused repetitive behaviors such as trichotillomania and skin picking disorder) and eating disorders, which can have dermatologic effects; (3) the direct effect of physical or sexual abuse or catastrophic life events (eg, earthquakes) on the skin; and (4) as a result of significant alterations in hypothalamic-pituitary-adrenal and sympatho-adrenal medullary axes, which can affect neuroendocrine and immune functions, and can lead to exacerbations of stress-reactive inflammatory dermatoses such as psoriasis, chronic urticaria, and atopic dermatitis. Elevated levels of inflammatory biomarkers and impaired epidermal barrier function have been reported in situations involving sustained psychologic stress and sleep deprivation. Some PTSD patients show hypothalamic-pituitary-adrenal axis hyporesponsiveness and higher circulating T lymphocytes, which can exacerbate immune-mediated dermatologic disorders. PTSD should be considered an underlying factor in the chronic, recurrent, or treatment-resistant stress-reactive dermatoses and in patients with self-induced dermatoses. Copyright © 2017 Elsevier Inc. All rights reserved.
Meister, Rebecca Elisabeth; Princip, Mary; Schnyder, Ulrich; Barth, Jürgen; Znoj, Hansjörg; Schmid, Jean-Paul; Wittmann, Lutz; von Känel, Roland
Acute myocardial infarction (MI) is a life-threatening condition, leading to immediate fear and distress in many patients. Approximately 18% of patients develop posttraumatic stress disorder in the aftermath of MI. Trait resilience has shown to be a protective factor for the development of posttraumatic stress disorder. However, whether this buffering effect has already an impact on peritraumatic distress and applies to patients with MI is elusive. We investigated 98 consecutive patients with acute MI within 48 hours after having reached stable circulatory conditions and 3 months thereafter. Peritraumatic distress was assessed retrospectively with three single-item questions about pain, fear, and helplessness during MI. All patients completed the Posttraumatic Diagnostic Scale (PDS) and the Resilience Scale to self-rate posttraumatic stress and trait resilience. Multivariate models adjusting for sociodemographic and medical factors showed that trait resilience was not associated with peritraumatic distress, but significantly so with posttraumatic stress. Patients with greater trait resilience showed lower PDS scores (b = -0.06, p resilience did not emerge as a moderator of this relationship. The findings suggest that trait resilience does not buffer the perception of acute MI as stressful per se but may enhance better coping with the traumatic experience in the longer term, thus preventing the development of MI-associated posttraumatic stress. Trait resilience may play an important role in posttraumatic stress symptoms triggered by medical diseases such as acute MI.
Full Text Available Purpose: To examine the potential effects of eye movement desensitization and reprocessing (EMDR in children with epilepsy-related posttraumatic stress and/or anxiety symptoms, using a case series design. Methods: Five children (aged 8–18 with epilepsy identified for seizure-related posttraumatic stress and/or anxiety symptoms were treated with EMDR. To examine potential treatment effects, posttraumatic stress and anxiety symptoms were assessed (CRTI and SCARED pre- and post-EMDR and at 3-month follow-up. Normative deviation scores were calculated to examine the severity of seizure-related posttraumatic stress and anxiety symptoms over time. The reliable change index was calculated for pre- to posttreatment change of seizure-related posttraumatic stress and/or anxiety symptoms. Results: Before EMDR, overall or subscale scores indicated that all children had (subclinical seizure-related posttraumatic stress symptoms and/or anxiety symptoms. Directly after EMDR, most children showed significant and/or clinical individual improvement, and these beneficial effects were maintained or reached at follow-up. The mean number of sessions was 2 (range 1–3, 45 min per session. Conclusions: In case of seizure-related posttraumatic stress and/or anxiety, this study indicates that EMDR is a potentially successful quick and safe psychological treatment for children with epilepsy.
Effective Health Care Research Consortium
Trauma focused cognitive behavioural therapy (TFCBT), eye movement desensitisation and reprocessing (EMDR), stress management, and group TFCBT reduce traumatic symptoms in post-traumatic stress disorder.
Anwar, Jasim; Mpofu, Elias; Matthews, Lynda R; Brock, Kaye E
This study sought to predict posttraumatic stress disorder (PTSD) from women's reproductive health events after an earthquake experience. Data on antenatal care, pregnancy outcomes, family planning, socioeconomic status, earthquake experiences, and mental health were collected from a random sample of 425 women of reproductive age using the Centers for Disease Control and Prevention Reproductive Health Assessment Toolkit and the Harvard Trauma Questionnaire. Data were analyzed using multivariate regression analysis to predict PTSD symptoms from posttrauma care variables and reproductive health events. Restricted social participation, use of temporary accommodation, pregnancy complications, and use of injectable contraceptives were significant risk factors of PTSD. These factors may be exacerbated by the social context of conservative societies, traditions about health care-seeking behavior, and access to health care. Antecedent reproductive health events influence women's reaction to major trauma including events such as an earthquake.
Norris, Fran H; Murphy, Arthur D; Baker, Charlene K; Perilla, Julia L; Rodriguez, Francisco Gutiérrez; Rodriguez, José de Jesús Gutiérrez
Prevalence rates of trauma and posttraumatic stress disorder (PTSD) were estimated from a probability sample of 2,509 adults from 4 cities in Mexico. PTSD was assessed according to Diagnostic and Statistical Manual of Mental Disorders (American Psychiatric Association, 1994) criteria using the Composite International Diagnostic Interview (CIDI; WHO, 1997). Lifetime prevalence of exposure and PTSD were 76% and 11.2%, respectively. Risk for PTSD was highest in Oaxaca (the poorest city), persons of lower socioeconomic status, and women. Conditional risk for PTSD was highest following sexual violence, but nonsexual violence and traumatic bereavement had greater overall impact because of their frequency. Of lifetime cases, 62% became chronic; only 42% received medical or professional care. The research demonstrates the importance of expanding the epidemiologic research base on trauma to include developing countries around the world. ((c) 2003 APA, all rights reserved)
Lolk, Mette; Byberg, Stine; Carlsson, Jessica
BACKGROUND: In a cohort of migrants in Denmark, we compared somatic disease incidence among migrants diagnosed with posttraumatic stress disorder (PTSD) and depression with migrants without a diagnosed psychiatric disorder. METHODS: The study builds on a unique cohort of migrants who obtained...... for the implementation of the project (No 2012-41-0065). RESULTS: Our results showed that migrants diagnosed with PTSD and depression had significantly higher rates of somatic diseases compared with migrants without diagnosed psychiatric disorders - especially, infectious disease (IRR, 1.89; 95% CI, 1.45-2.48; p ....01), neurological disease (IRR, 2.35; 95% CI, 1.91-2.91; p Migrants with PTSD and depression had a significantly higher rates of somatic comorbidity compared...
Czaja, Angela S; Moss, Marc; Mealer, Meredith
In their work, pediatric acute care nurses may encounter traumatic events and be at risk for posttraumatic stress disorder (PTSD). This survey-based study examines the potential diagnosis of PTSD among nurses at a tertiary children's hospital with a Level 1 trauma center. Twenty-one percent of respondents had strong PTSD symptoms without significant difference between units. Nurses with potential PTSD had more comorbid symptoms of anxiety, depression, and burnout and were more often considering a career change. Furthermore, symptoms affected not only their work but also their personal lives. Future research should focus upon identifying pediatric nurses with PTSD to provide therapeutic interventions and reducing high-risk events and their potential impact. Copyright © 2012 Elsevier Inc. All rights reserved.
Svenningsen, Helle; Egerod, Ingrid; Christensen, Doris
in the ICU and symptoms of PTSD in 8% (2 months) and 6% (6 months) after ICU-discharge. Recall of ICU stay was present in 93%. Associations between ICU-delirium and post-discharge PTSD-symptoms were weak and insignificant. Memories of delusions were significantly associated with anxiety after two months....... Remaining associations between types of ICU-memories and prevalence of post-discharge symptoms of PTSD, anxiety, and depression were insignificant after adjusting for age. Incidence of ICU-delirium was unaffected by preadmission use of psychotropic drugs. Prevalence of PTSD-symptoms was unaffected by use......Introduction. Long-term psychological consequences of critical illness are receiving more attention in recent years. The aim of our study was to assess the correlation of ICU-delirium and symptoms of posttraumatic stress disorder (PTSD) anxiety and depression after ICU-discharge in a Danish cohort...
Neylan, Thomas C; Lenoci, Maryanne; Rothlind, Johannes; Metzler, Thomas J; Schuff, Norbert; Du, An-Tao; Franklin, Kristin W; Weiss, Daniel S; Weiner, Michael W; Marmar, Charles R
This study compared attention and declarative memory in a sample of combat veterans with posttraumatic stress disorder (PTSD, n = 24) previously reported to have reduced concentrations of the hippocampal neuronal marker N-acetyl aspartate (NAA), but similar hippocampal volume compared to veteran normal comparison participants (n = 23). Healthy, well-educated males with combat-related PTSD without current depression or recent alcohol/drug abuse did not perform differently on tests of attention, learning, and memory compared to normal comparison participants. Further, hippocampal volume, NAA, or NAA/Creatine ratios did not significantly correlate with any of the cognitive measures when adjustments for multiple comparisons were made. In this study, reduced hippocampal NAA did not appear to be associated with impaired declarative memory.
Samuelson, Kristin W; Neylan, Thomas C; Metzler, Thomas J; Lenoci, Maryanne; Rothlind, Johannes; Henn-Haase, Clare; Choucroun, Gerard; Weiner, Michael W; Marmar, Charles R
Studies have shown differences in neuropsychological functioning between groups with posttraumatic stress disorder (PTSD) and control participants. Because individuals with PTSD often have a history of comorbid alcohol abuse, the extent to which an alcohol confound is responsible for these differences remains a concern. The current study compares neuropsychological testing scores in 4 groups of veterans with and without PTSD (PTSD+ and PTSD-, respectively) and with and without a history of alcohol abuse (ETOH+ and ETOH-, respectively): n for PTSD+/ETOH- = 30, n for PTSD+/ETOH- = 37, n for PTSD-/ETOH+ = 30, and n for PTSD-/ETOH- = 31. Results showed that PTSD, when alcohol, educational level, vocabulary, and depression are controlled for, was associated with decreased verbal memory, attention, and processing speed performance. Alcohol abuse history was associated with decreased visual memory performance. By controlling for alcohol and depression, the authors can more conclusively demonstrate that verbal memory and attention differences are associated with PTSD.
McDonald, Catherine C; Deatrick, Janet A
Youth face trauma that can cause posttraumatic stress (PTS). (1) To identify the family phenomena used in youth PTS research; and(2) to critically examine the research findings regarding the relationship between family phenomena and youth PTS. Systematic literature review in PsycInfo, PILOTS, CINAHL, and MEDLINE. Twenty-six empirical articles met inclusion criteria. Measurement of family phenomena included family functioning,support, environment, expressiveness, relationships, cohesion, communication, satisfaction, life events related to family, parental style of influence, and parental bonding. Few studies gave clear conceptualization of family or family phenomena. Empirical findings from the 26 studies indicate inconsistent empirical relationships between family phenomena and youth PTS, although a majority of the prospective studies support a relationship between family phenomena and youth PTS. Future directions for leadership by psychiatric nurses in this area of research and practice are recommended.
Borowa, Dominika; Robitschek, Christine; Harmon, Kevin Andrew; Shigemoto, Yuki
This study explored the extent to which personal growth initiative (PGI) may predict posttraumatic stress and growth in student service members/veterans (SSM/V). Participants were 136 SSM/V (79% men) representing multiple branches of the armed forces. Forty-four percent of participants reported having combat experience. Data collection occurred from October 2013 to February 2014. Data were collected via a Web-based survey that included demographics and measures of personal growth initiative, posttraumatic stress, posttraumatic growth, and perceived social support. Results indicated that PGI is not a unique predictor of posttraumatic stress but is a unique predictor of higher levels of posttraumatic growth. PGI appears to be at least as important as perceived social support in facilitating growth in SSM/V. This study provides further evidence for PGI's potential to facilitate growth after a traumatic event.
indicated with italics and bolding (p < .05; p < .01; p < .001). PTSD = Postraumatic Stress Disorder . Patterns of Adjustment Among U.S. Marines 33...of war or disaster, posttraumatic stress disorder (PTSD) prevalence rates have become a scientifically accepted gauge of the emotional impact of...combat trauma is a risk factor for mental health problems, particularly posttraumatic stress disorder (Boscarino, 1995; Hoge et al., 2004). As a
traumatic stress disorder (exposure) and subsequent 3 year weight change (outcome). Original Article Obesity EPIDEMIOLOGY/GENETICS www.obesityjournal.org...28:563-570. 7. Pagoto SL, Schneider KL, Bodenlos JS et al. Association of post-traumatic stress disorder and obesity in a nationally representative...al. Posttraumatic stress disorder and obesity : evidence for a risk association. Am J Prev Med 2009;36:1-8. 16. Smith TC, Jacobson IG, Hooper TI et al
Full Text Available The aim of this study was to determine the incidence of Post-Traumatic Stress Disorder (PTSD, the characteristics of stress-related events, and the risk factors for the development of PTSD. The total patient sample consisted of 100 Bosnian war veterans. Watson’s PTSD module was used in establishing PTSD diagnosis. Patients fulfilled the following questionnaires: personal data form, Posttraumatic Symptom Scale PTSS-10 (Holen, Impact of Event Scale (Horowitz, Life Event Scale, and Eysenck Personality Inventory. PTSD was diagnosed in 30% of the examined patients. Larger number of stress-related events, particularly of those regarded as life-threatening, wounding/death of a close person, and material losses were more frequent in persons with PTSD. The risk factors for the development of PTSD in this study were: age (30-40, marital status (married, lower level of education, the front-line combat exposure, neurotic manifestations, family problems in childhood, and neuroticism.
Full Text Available Background: Injured trauma victims are at risk of developing Posttraumatic Stress Disorder (PTSD and other post-trauma psychopathology. So far, interventions using cognitive behavioral techniques (CBT have proven most efficacious in treating early PTSD in highly symptomatic individuals. No early intervention for the prevention of PTSD for all victims has yet proven effective. In the acute psychosocial care for trauma victims, there is a clear need for easily applicable, accessible, cost-efficient early interventions. Objective: To describe the design of a randomized controlled trial (RCT evaluating the effectiveness of a brief Internet-based early intervention that incorporates CBT techniques with the aim of reducing acute psychological distress and preventing long-term PTSD symptoms in injured trauma victims. Method: In a two armed RCT, 300 injured trauma victims from two Level-1 trauma centers in Amsterdam, the Netherlands, will be assigned to an intervention or a control group. Inclusion criteria are: being 18 years of age or older, having experienced a traumatic event according to the diagnostic criteria of the DSM-IV and understanding the Dutch language. The intervention group will be given access to the intervention's website (www.traumatips.nl, and are specifically requested to login within the first month postinjury. The primary clinical study outcome is PTSD symptom severity. Secondary outcomes include symptoms of depression and anxiety, quality of life, and social support. In addition, a cost-effectiveness analysis of the intervention will be performed. Data are collected at one week post-injury, prior to first login (baseline, and at 1, 3, 6 and 12 months. Analyses will be on an intention-to-treat basis. Discussion: The results will provide more insight into the effects of preventive interventions in general, and Internet-based early interventions specifically, on acute stress reactions and PTSD, in an injured population, during the
Blanchette, Isabelle; Caparos, Serge
The purpose of the study was to examine how working memory (WM) may be related to exposure to potentially traumatic events and symptoms of post-traumatic stress disorder (PTSD). In four studies, we measured WM function using adaptations of the running span and the reading span tasks. We compared the performance of women reporting experiences of sexual abuse to control participants (total n = 144 controls and 84 victims). We measured severity of the sexual abuse experiences as well as exposure to general life stress. In all studies, trauma-exposed participants showed significantly lower WM function compared to control participants. In addition to traditional null hypothesis testing, we used a mini-meta analysis to estimate the combined estimated effect size of this difference, which was in the moderate range (d = 0.43 with 0.15-0.70 95% confidence interval). Regression equations showed that PTSD symptoms did not mediate the relationship between trauma exposure and WM function. Our results show that trauma exposure per se can be associated with important cognitive correlates even in individuals who do not develop psychopathological reactions.
Levin, Ross; Nielsen, Tore A.
Nightmares are common, occurring weekly in 4%-10% of the population, and are associated with female gender, younger age, increased stress, psychopathology, and dispositional traits. Nightmare pathogenesis remains unexplained, as do differences between nontraumatic and posttraumatic nightmares (for those with or without posttraumatic stress…
Rodgers, Ali B; Bale, Tracy L
Altered stress reactivity is a predominant feature of posttraumatic stress disorder (PTSD) and may reflect disease vulnerability, increasing the probability that an individual will develop PTSD following trauma exposure. Environmental factors, particularly prior stress history, contribute to the developmental programming of the hypothalamic-pituitary-adrenal stress axis. Critically, the consequences of stress experiences are transgenerational, with parental stress exposure impacting stress reactivity and PTSD risk in subsequent generations. Potential molecular mechanisms underlying this transmission have been explored in rodent models that specifically examine the paternal lineage, identifying epigenetic signatures in male germ cells as possible substrates of transgenerational programming. Here, we review the role of these germ cell epigenetic marks, including posttranslational histone modifications, DNA methylation, and populations of small noncoding RNAs, in the development of offspring stress axis sensitivity and disease risk. Copyright © 2015 Society of Biological Psychiatry. Published by Elsevier Inc. All rights reserved.
Weiss, Jonathan A; Cappadocia, M Catherine; Tint, Ami; Pepler, Debra
Bullying victimization is commonly associated with anxiety among individuals with and without Autism Spectrum Disorder (ASD), and both bullying victimization and anxiety are more prevalent among youth with ASD than in the general population. We explored individual and contextual factors that relate to anxiety in adolescents and young adults with ASD who also experience bullying victimization. Participants included 101 mothers of adolescents and young adults diagnosed with ASD. Hierarchical multiple regression analyses were conducted to investigate the relationship between bullying victimization and anxiety in children with ASD, as well as parenting stress as a potential moderator of that relationship. Findings indicate that parenting stress moderates the association between bullying victimization and anxiety. The severity of anxiety was most strongly associated with bullying victimization when mothers reported high levels of stress. Implications for interventions that assist parents with coping and address bullying victimization are discussed. © 2015 International Society for Autism Research, Wiley Periodicals, Inc.
Reiter, Karen; Andersen, Søren Bo; Carlsson, Jessica
Neurofeedback is an alternative, noninvasive approach used in the treatment of a wide range of neuropsychiatric disorders, including posttraumatic stress disorder (PTSD). Many different neurofeedback protocols and methods exist. Likewise, PTSD is a heterogeneous disorder. To review the evidence on effectiveness and preferred protocol when using neurofeedback treatment on PTSD, a systematic search of PubMed, PsychInfo, Embase, and Cochrane databases was undertaken. Five studies were included in this review. Neurofeedback had a statistically significant effect in three studies. Neurobiological changes were reported in three studies. Interpretation of results is, however, limited by differences between the studies and several issues regarding design. The optimistic results presented here qualify neurofeedback as probably efficacious for PTSD treatment.
Hasanović, Mevludin; Srabović, Sehaveta; Rasidović, Munevera; Sehović, Mirela; Hasanbasić, Emir; Husanović, Jasminka; Hodzić, Renata
The 1992-1995 war in Bosnia and Herzegovina (BH) has had a tremendous impact on civilians; thousands of inhabitants were left with numerous traumatic experiences. Many children suffered or witnessed horrifying acts of violence and aggression. Although young trauma victims are often resilient, many experience mental health difficulties, including PTSD. The aim of the study was to estimate whether psychosocial support given by the School Project of Humanitarian Association of " Prijateljice" reduced posttraumatic consequences in students in primary and secondary schools in Bosnia and Herzegovina after 1992-1995 war. A stratified sample of 336 students in primary and secondary schools located in two entities of North-East Bosnia and Herzegovina, involved in psychosocial support, was compared with 72 voluntarily selected same-age students from the same schools who were not involved in this project. Data were collected on two occasions, beginning of December 2005 and end of May 2006, by using a self-evaluation survey method for measuring symptoms of posttraumatic stress disorder (PTSD) according to DSM IV. The Index of Children Post-traumatic reactions were used. The severity of PTSD symptoms among students involved in the School Project decreased from (mean+/-standard deviation=35.3+/-10.2 to 26.7+/-8.7) (t=13.1, PSchool Project resulted in significant reduction of PTSD symptoms' severity.
Cuevas, Carlos A.; Finkelhor, David; Ormrod, Richard; Turner, Heather
Research examining childhood abuse has shown an association between victimization and psychiatric diagnoses (e.g., posttraumatic stress disorder, depression). Historically, psychiatric diagnoses have been emphasized as a consequence of victimization, with less research examining if it also functions as a risk factor for further victimization,…
Kröger, Christoph; Frantz, Inga; Friel, Pauline; Heinrichs, Nina
Background and Objectives: Currently, there is a large number of refugees that are coming to Germany from (civil) war zones. The aim of this study was to estimate the extent of posttraumatic stress and depressive symptoms amongst asylum seekers in Germany. Methods: In the summer of 2015, 280 adult refugees (88,2% men) were interviewed with the support of translators in the Lower Saxony State Refugee Reception Center, Brunswick. Data was categorized due to country of origin (Balkan States, Middle East, Northern Africa, Rest of Africa). The Posttraumatic Diagnostic Scale-8 (PDS-8) and the Patient-Health-Questionnaire (PHQ-8) were employed as screening measures. If the threshold values of 12 in the PDS-8 or 15 in the PHQ are exceeded, respectively, the diagnosis of PTSD or depression is highly likely. Results: Participants reported an overall high number of potentially traumatic experiences (72,5% war experiences; 67,9% violent attacks; 51,4% another very burdensome experience; 50,0% torture; 47,9% imprisonment; 11,1% sexual assault), whereby multiple answers were possible. The prevalence rates for possible PTSD were 16,1% (Balkan States), 20,5% (Middle East), 23,4% (Rest of Africa) and 28,1% (Northern Africa); rates for a possible depression varied between the countries of origin from 17,9, 35,9, 28,1 to 24,0%, respectively. Conclusions: Compared to the German population, the rates of traumatic experiences and the prevalence of a possible PTSD were significantly higher amongst asylum seekers of the present sample; this was not the case for depression. The integration of affected asylum seekers may be considerably complicated due to health impairments, e. g. with regard to learning the German language and admission to educational or occupational services. © Georg Thieme Verlag KG Stuttgart · New York.
Lipinska, Malgorzata; Timol, Ridwana; Kaminer, Debra; Thomas, Kevin G F
Successful memory consolidation during sleep depends on healthy slow-wave and rapid eye movement sleep, and on successful transition across sleep stages. In post-traumatic stress disorder, sleep is disrupted and memory is impaired, but relations between these two variables in the psychiatric condition remain unexplored. We examined whether disrupted sleep, and consequent disrupted memory consolidation, is a mechanism underlying declarative memory deficits in post-traumatic stress disorder. We recruited three matched groups of participants: post-traumatic stress disorder (n = 16); trauma-exposed non-post-traumatic stress disorder (n = 15); and healthy control (n = 14). They completed memory tasks before and after 8 h of sleep. We measured sleep variables using sleep-adapted electroencephalography. Post-traumatic stress disorder-diagnosed participants experienced significantly less sleep efficiency and rapid eye movement sleep percentage, and experienced more awakenings and wake percentage in the second half of the night than did participants in the other two groups. After sleep, post-traumatic stress disorder-diagnosed participants retained significantly less information on a declarative memory task than controls. Rapid eye movement percentage, wake percentage and sleep efficiency correlated with retention of information over the night. Furthermore, lower rapid eye movement percentage predicted poorer retention in post-traumatic stress disorder-diagnosed individuals. Our results suggest that declarative memory consolidation is disrupted during sleep in post-traumatic stress disorder. These data are consistent with theories suggesting that sleep benefits memory consolidation via predictable neurobiological mechanisms, and that rapid eye movement disruption is more than a symptom of post-traumatic stress disorder. © 2014 European Sleep Research Society.
Hansen, Maj; Elklit, Ask
or self-selecting samples. To overcome these limitations, we investigated the estimated prevalence rate of acute stress disorder (ASD) and PTSD and predictors of PTSD severity in a Danish cohort study of all bank employees exposed to robbery during one year (N = 614). A total of 450 employees (73...... %) filled out the first questionnaire a week after the robbery (T1). Of these, 371 employees (82 %) filled out the second questionnaire six months after the robbery (T2). Results showed that 11.1% of the participants suffered from ASD (T1) and 6.2 % suffered from PTSD (T2). The results of a hierarchical...... by a statistical artifact (negative suppression). The strongest predictors of PTSD severity were ASD severity followed by negative cognitions about self. This indicates that victims with high levels of ASD are at increased risk of developing PTSD following bank robbery. Thus, screening for PTSD following bank...
Taylor, Benjamin Eric; Chekaluk, Eugene; Bennett, Joanne
Post-traumatic stress disorder is common among North Korean refugees who have fled their country for economic, financial and humanitarian reasons. Co-morbid depression and anxiety are also common among North Korean refugees, due to the difficulties they have faced within their country and during their escape journey. Depression and anxiety complicate treatment for post-traumatic stress disorder, and lead to poorer outcomes. Thus, the aim of the present study was to provide a meta-analysis of studies investigating post-traumatic stress disorder, depression, and anxiety among North Korean refugees. Selected articles were published in English, and included measures of post-traumatic stress, and/or depression and anxiety. 10 studies were included in the depression meta-analysis, and 6 in the anxiety meta-analysis. A random-effects model revealed strong, significant associations between post-traumatic stress and depression, r=0.63, 95% CI (0.51, 0.72), ppost-traumatic stress, depression and anxiety were higher among adults and those with more than five years outside of North Korea. Depression appears to be an important treatment focus for North Korean refugees with post-traumatic stress.
This dissertation investigated the impact of dissociation on the development of posttraumatic stress disorder (PTSD), on memory formation, and on treatment efficacy. First, the predictive power of peritraumatic psychological and somatoform dissociation was investigated in two studies using a
Ipser, Jonathan C; Stein, Dan J
Post-traumatic stress disorder (PTSD) is a prevalent and disabling disorder. Recognition of neurobiological abnormalities associated with this condition suggests the potential efficacy of medication in its treatment...
Committee on the Assessment of Ongoing Effects in the Treatment of Posttraumatic Stress Disorder; Institute of Medicine
.... However, the signature injuries sustained by United States military personnel in these most recent conflicts are blast wounds and the psychiatric consequences to combat, particularly posttraumatic stress disorder (PTSD...
Post-traumatic stress disorder is highly prevalent among individuals who suffer from opioid use disorder. Compared to individuals with opioid use disorder alone, those with post-traumatic stress disorder have a worse course of illness, occupational functioning, and physical health. The neurobiological pathways underlying each disorder overlap substantially, and there are multiple pathways through which these disorders may interact. This narrative review explores evidence underpinning 3 explanatory perspectives on comorbid post-traumatic stress disorder and opioid use disorder: The opioid susceptibility model (a.k.a.: the Self-Medication Hypothesis), the post-traumatic stress disorder susceptibility model, and the common factors model. Diagnostic implications, treatment implications, and directions for future research are discussed.
Meli, Laura; Alcántara, Carmela; Sumner, Jennifer A; Swan, Brendan; Chang, Bernard P; Edmondson, Donald
Post-traumatic stress disorder due to acute cardiovascular events may be uniquely defined by enduring perceptions of somatic threat. We tested whether post-traumatic stress disorder at 1 month post-acute coronary syndrome indeed required both high peritraumatic threat during the acute coronary syndrome and ongoing cardiac threat perceptions. We assessed peritraumatic threat during emergency department enrollment of 284 patients with a provisional acute coronary syndrome diagnosis and cardiac threat perceptions and post-traumatic stress disorder symptoms 1 month post-discharge. In a multiple regression model with adjustment for important covariates, emergency department threat perceptions were associated with higher 1 month post-traumatic stress disorder symptoms only among those with high levels of ongoing cardiac threat.
Expert-reviewed information summary about post-traumatic stress and related symptoms in cancer patients, cancer survivors, and their family members. Assessment and treatment of these symptoms are discussed.
van Liempt, S.
Background: Sleep facilitates the consolidation of fear extinction memory. Disrupted sleep has been proposed as a vulnerability factor for the development of posttraumatic stress disorder (PTSD). Moreover, nightmares and insomnia are hallmark symptoms of PTSD, possibly interfering with fear
Polak, A. Rosaura; Witteveen, Anke B.; Reitsma, Johannes B.; Olff, Miranda
Background: Although posttraumatic stress disorder (PTSD) has been associated with disturbances in verbal memory, studies examining executive functioning in PTSD show mixed results. Methods: A systematic review and meta-analysis were performed to compare executive functioning in patients with
Palmieri, Patrick A; Fitzgerald, Louise F
Posttraumatic stress disorder (PTSD) factor analytic research to date has not provided a clear consensus on the structure of posttraumatic stress symptoms. Seven hypothesized factor structures were evaluated using confirmatory factor analysis of the Posttraumatic Stress Disorder Checklist, a paper-and-pencil measure of posttraumatic stress symptom severity, in a sample of 1,218 women who experienced a broad range of workplace sexual harassment. The model specifying correlated re-experiencing, effortful avoidance, emotional numbing, and hyperarousal factors provided the best fit to the data. Virtually no support was obtained for the Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM-IV; American Psychiatric Association, 1994) three-factor model of re-experiencing, avoidance, and hyperarousal factors. Different patterns of correlations with external variables were found for the avoidance and emotional numbing factors, providing further validation of the supported model.
Thomas Niederkrotenthaler; Erin M Parker; Fernando Ovalle; Rebecca E Noe; Jeneita Bell; Likang Xu; Melissa A Morrison; Caitlin E Mertzlufft; David E Sugerman
Objectives We analyzed tornado-related injuries seen at hospitals and risk factors for tornado injury, and screened for post-traumatic stress following a statewide tornado-emergency in Alabama in April 2011...
Hendriks, L.; Kleine, R.A. de; Heyvaert, M.; Becker, E.S.; Hendriks, G.J.; Minnen, A. van
Background: The current study evaluated the effectiveness and safety of intensive prolonged exposure (PE) targeting adolescent patients with complex posttraumatic stress disorder (PTSD) and comorbid disorders following multiple interpersonal trauma. Methods: Ten adolescents meeting full diagnostic
Miron, Lynsey R.; Orcutt, Holly K.; Kumpula, Mandy J.
Schools have become a common incident site for targeted mass violence, including mass shootings. Although exposure to mass violence can result in significant distress, most individuals are able to fully recover over time, while a minority develop more pervasive pathology, such as PTSD. The present study investigated how several pre- and post-trauma factors predict posttraumatic stress symptoms (PTSS) in both the acute and distal aftermath of a campus mass shooting using a sample with known le...
Full Text Available The impact of traumatic events is well documented within the clinical psychology literature where it is recognized that people who experience traumatic events may go on to develop posttraumatic stress disorder (PTSD. At first glance one might ask what the relevance of positive psychology is to the study of trauma. But a number of literatures and philosophies throughout human history have conveyed the idea that there is personal gain to be found in suffering. The observation that stressful and traumatic events can provoke positive psychological changes is also contained in the major religions of Buddhism, Christianity, Hinduism, Islam, and Judaism. Within existential philosophy and humanistic psychology it has also been recognized that positive changes can come about as a result of suffering. But it is only within the last decade that the topic of growth following adversity has become a focus for empirical work. In this paper I will provide an overview of the subject and the research we have conducted at the Centre for Trauma, Resilience, and Growth (CTRG.
Loos, Sabine; Wolf, Saskia; Tutus, Dunja; Goldbeck, Lutz
The risk for children and adolescents to be exposed to a potentially traumatic event (PTE) is high. The present study examines the frequency of PTEs in children and adolescents with Posttraumatic Stress Disorder (PTSD), the type of index trauma, and its relation to PTSD symptom severity and gender. A clinical sample of 159 children and adolescents between 7-16 years was assessed using the Clinician-Administered PTSD Scale for Children and Adolescents (CAPS-CA). All reported PTEs from the checklist were analyzed according to frequency. The index events were categorized according to the following categories: cause (random vs. intentional), relation to offender (intrafamilial vs. extrafamilial), patient's role (victim, witness or vicarious traumatization), and type of PTE (physical or sexual violence). Relation between categories and PTSD symptom severity and sex were analyzed with inferential statistics. On average participants reported five PTEs, most frequently physical violence without weapons (57.9%), loss of loved person through death (45.9%), and sexual abuse/assaults (44%). The most frequent index traumata were intentional (76.7%). Regarding trauma type, there was a significant difference concerning higher symptom severity in children and adolescents who experienced sexual abuse/assault compared to physical violence (t=-1.913(109), p=0.05). A significantly higher symptom severity was found for girls compared to boys for the trauma categories extrafamilial offender (z=-2,27, p=0.02), victim (z=-2,11, p=0,04), and sexual abuse/assault (z=-2,43, p=0,01). Clinical and diagnostic implications are discussed in relation to the amendments of PTSD diagnostic criteria in DSM-5.
Vignato, Julie; Georges, Jane M; Bush, Ruth A; Connelly, Cynthia D
To report an analysis of the concept of perinatal post-traumatic stress disorder. Prevalence of perinatal post-traumatic stress disorder is rising in the USA, with 9% of the U.S. perinatal population diagnosed with the disorder and an additional 18% being at risk for the condition. Left untreated, adverse maternal-child outcomes result in increased morbidity, mortality and healthcare costs. Concept analysis via Walker and Avant's approach. The databases Cumulative Index to Nursing and Allied Health Literature (CINAHL), Medline, Academic Search Premier and PsychINFO were searched for articles, written in English, published between 2006-2015, containing the terms perinatal and post-traumatic stress disorder. Perinatal post-traumatic stress disorder owns unique attributes, antecedents and outcomes when compared to post-traumatic stress disorder in other contexts, and may be defined as a disorder arising after a traumatic experience, diagnosed any time from conception to 6 months postpartum, lasting longer than 1 month, leading to specific negative maternal symptoms and poor maternal-infant outcomes. Attributes include a diagnostic time frame (conception to 6 months postpartum), harmful prior or current trauma and specific diagnostic symptomatology defined in the Diagnostic and Statistical Manual of Mental Disorders, 5th edition. Antecedents were identified as trauma (perinatal complications and abuse), postpartum depression and previous psychiatric history. Consequences comprised adverse maternal-infant outcomes. Further research on perinatal post-traumatic stress disorder antecedents, attributes and outcomes in ethnically diverse populations may provide clinicians a more comprehensive framework for identifying and treating perinatal post-traumatic stress disorder. Nurses are encouraged to increase their awareness of perinatal post-traumatic stress disorder for early assessment and intervention, and prevention of adverse maternal-infant outcomes. © 2017 John Wiley
Read, Jennifer P.; Radomski, Sharon; Borsari, Brian
Students with trauma and posttraumatic stress are disproportionately at risk for heavy drinking and for alcohol-related consequences. Brief motivational interventions (BMIs) have been shown to reduce hazardous drinking in college students, and could serve as a first-line approach to reduce heavy drinking in students with trauma and posttraumatic stress (PTS). Yet the standard BMI format may not adequately address the factors that lead to hazardous drinking in these students. Here, we review t...
Dautovic, Elmedina; de Roos, Carlijn; van Rood, Yanda; Dommerholt, Agnes; Rodenburg, Roos
Purpose To examine the potential effects of eye movement desensitization and reprocessing (EMDR) in children with epilepsy-related posttraumatic stress and/or anxiety symptoms, using a case series design. Methods Five children (aged 8–18) with epilepsy identified for seizure-related posttraumatic stress and/or anxiety symptoms were treated with EMDR. To examine potential treatment effects, posttraumatic stress and anxiety symptoms were assessed (CRTI and SCARED) pre- and post-EMDR and at 3-month follow-up. Normative deviation scores were calculated to examine the severity of seizure-related posttraumatic stress and anxiety symptoms over time. The reliable change index was calculated for pre- to posttreatment change of seizure-related posttraumatic stress and/or anxiety symptoms. Results Before EMDR, overall or subscale scores indicated that all children had (sub)clinical seizure-related posttraumatic stress symptoms and/or anxiety symptoms. Directly after EMDR, most children showed significant and/or clinical individual improvement, and these beneficial effects were maintained or reached at follow-up. The mean number of sessions was 2 (range 1–3, 45 min per session). Conclusions In case of seizure-related posttraumatic stress and/or anxiety, this study indicates that EMDR is a potentially successful quick and safe psychological treatment for children with epilepsy. Highlights of the article The first study to examine the potential effects of EMDR to reduce clinical seizure-related posttraumatic stress symptoms and/or anxiety symptoms in children with epilepsy. After 1–3 EMDR (45 min) sessions, positive treatment effects were found on a range of seizure-related PTSD symptoms and/or anxiety symptoms. During treatment, no seizures, absences, or any other adverse events were observed; the seizure diaries showed that none of the children experienced more seizures (or an unusual pattern) after treatment. At the reevaluation of EMDR, all children and parents
Ursano, Robert J; McKibben, Jodi B A; Reissman, Dori B; Liu, Xian; Wang, Leming; Sampson, Robert J; Fullerton, Carol S
There is a paucity of research investigating the relationship of community-level characteristics such as collective efficacy and posttraumatic stress following disasters. We examine the association of collective efficacy with probable posttraumatic stress disorder and posttraumatic stress disorder symptom severity in Florida public health workers (n = 2249) exposed to the 2004 hurricane season using a multilevel approach. Anonymous questionnaires were distributed electronically to all Florida Department of Health personnel nine months after the 2004 hurricane season. The collected data were used to assess posttraumatic stress disorder and collective efficacy measured at both the individual and zip code levels. The majority of participants were female (80.42%), and ages ranged from 20 to 78 years (median = 49 years); 73.91% were European American, 13.25% were African American, and 8.65% were Hispanic. Using multi-level analysis, our data indicate that higher community-level and individual-level collective efficacy were associated with a lower likelihood of having posttraumatic stress disorder (OR = 0.93, CI = 0.88-0.98; and OR = 0.94, CI = 0.92-0.97, respectively), even after adjusting for individual sociodemographic variables, community socioeconomic characteristic variables, individual injury/damage, and community storm damage. Higher levels of community-level collective efficacy and individual-level collective efficacy were also associated with significantly lower posttraumatic stress disorder symptom severity (b = -0.22, p<0.01; and b = -0.17, p<0.01, respectively), after adjusting for the same covariates. Lower rates of posttraumatic stress disorder are associated with communities with higher collective efficacy. Programs enhancing community collective efficacy may be an important part of prevention practices and possibly lead to a reduction in the rate of posttraumatic stress disorder post-disaster.
Heir, Trond; Rosendal, Susanne; Bergh-Johannesson, Kerstin
Studies of short- and long-term mental effects of natural disasters have reported a high prevalence of post-traumatic stress. Less is known about disaster-exposed tourists repatriated to stable societies.......Studies of short- and long-term mental effects of natural disasters have reported a high prevalence of post-traumatic stress. Less is known about disaster-exposed tourists repatriated to stable societies....
Achilli, Julián; Rodríguez, María C; Folino, Jorge O
Crime consequences are not only a security problem; they are also a community health question. Because shop assistants are particularly exposed to crime victimization, they are at risk from suffering posttraumatic stress disorders. To describe posttraumatic symptomatology of crime victimized shop assistants and to explore the relationship between the symptoms and demographic, victim and situational factors. Self-reported information about mental symptomatology was gathered from 126 victimized shop assistants identified during cross-sectional study. Case and control groups were formed to explore association between symptomatology and crime and victim characteristics. The 20.6% of respondents reported information compatible with posttraumatic stress disorder; the 13 %, with moderate/severe depression and the 69.8% with adjustment disorder. The condition of being a case was associated with the violent characteristic of the crime, with the subtraction of goods and the economic value of the goods.
Wittmann, Lutz; Schredl, Michael; Kramer, Milton
This review summarizes the available knowledge on the phenomenology of posttraumatic dreams. Posttraumatic nightmares are reported by up to 70% of individuals suffering from posttraumatic stress disorder (PTSD). An extensive review of polysomnographic studies suggests that neither this high incidence nor the occurrence of posttraumatic nightmares throughout the sleep cycle can be explained by altered REM sleep parameters. The assumption that a reduction of dream recall may serve as a coping mechanism in PTSD patients is questionable. About 50% of posttraumatic dreams comprise exact replications of the traumatic events. Therefore dreams in PTSD do not have stereotypical content. Data characterizing non-replicative posttraumatic dreams and indicating a change in dream content over time must be considered preliminary. Occurrence of posttraumatic dreams is associated with psychopathological developments. Imagery Rehearsal Therapy has repeatedly been proven to be a valuable tool in treating patients suffering from posttraumatic dream disturbance. A deeper knowledge of posttraumatic dreams is essential for any theory of PTSD as well as for a better understanding of the overall function of dreaming. Copyright 2007 S. Karger AG, Basel.
Posttraumatic growth, depressive symptoms, posttraumatic stress symptoms, post-migration stressors and quality of life in multi-traumatized psychiatric outpatients with a refugee background in Norway.
Teodorescu, Dinu-Stefan; Siqveland, Johan; Heir, Trond; Hauff, Edvard; Wentzel-Larsen, Tore; Lien, Lars
Psychiatric outpatients with a refugee background have often been exposed to a variety of potentially traumatizing events, with numerous negative consequences for their mental health and quality of life. However, some patients also report positive personal changes, posttraumatic growth, related to these potentially traumatic events. This study describes posttraumatic growth, posttraumatic stress symptoms, depressive symptoms, post-migration stressors, and their association with quality of life in an outpatient psychiatric population with a refugee background in Norway. Fifty five psychiatric outpatients with a refugee background participated in a cross-sectional study using clinical interviews to measure psychopathology (SCID-PTSD, MINI), and four self-report instruments measuring posttraumatic growth, posttraumatic stress symptoms, depressive symptoms, and quality of life (PTGI-SF, IES-R, HSCL-25-depression scale, and WHOQOL-Bref) as well as measures of social integration, social network and employment status. All patients reported some degree of posttraumatic growth, while only 31% reported greater amounts of growth. Eighty percent of the patients had posttraumatic stress symptoms above the cut-off point, and 93% reported clinical levels of depressive symptoms. Quality of life in the four domains of the WHOQOL-Bref levels were low, well below the threshold for the'life satisfaction' standard proposed by Cummins. A hierarchic regression model including depressive symptoms, posttraumatic stress symptoms, posttraumatic growth, and unemployment explained 56% of the total variance found in the psychological health domain of the WHOQOL-Bref scale. Posttraumatic growth made the strongest contribution to the model, greater than posttraumatic stress symptoms or depressive symptoms. Post-migration stressors like unemployment, weak social network and poor social integration were moderately negatively correlated with posttraumatic growth and quality of life, and positively
Full Text Available Abstract Background Psychiatric outpatients with a refugee background have often been exposed to a variety of potentially traumatizing events, with numerous negative consequences for their mental health and quality of life. However, some patients also report positive personal changes, posttraumatic growth, related to these potentially traumatic events. This study describes posttraumatic growth, posttraumatic stress symptoms, depressive symptoms, post-migration stressors, and their association with quality of life in an outpatient psychiatric population with a refugee background in Norway. Methods Fifty five psychiatric outpatients with a refugee background participated in a cross-sectional study using clinical interviews to measure psychopathology (SCID-PTSD, MINI, and four self-report instruments measuring posttraumatic growth, posttraumatic stress symptoms, depressive symptoms, and quality of life (PTGI-SF, IES-R, HSCL-25-depression scale, and WHOQOL-Bref as well as measures of social integration, social network and employment status. Results All patients reported some degree of posttraumatic growth, while only 31% reported greater amounts of growth. Eighty percent of the patients had posttraumatic stress symptoms above the cut-off point, and 93% reported clinical levels of depressive symptoms. Quality of life in the four domains of the WHOQOL-Bref levels were low, well below the threshold for the’life satisfaction’ standard proposed by Cummins. A hierarchic regression model including depressive symptoms, posttraumatic stress symptoms, posttraumatic growth, and unemployment explained 56% of the total variance found in the psychological health domain of the WHOQOL-Bref scale. Posttraumatic growth made the strongest contribution to the model, greater than posttraumatic stress symptoms or depressive symptoms. Post-migration stressors like unemployment, weak social network and poor social integration were moderately negatively correlated with
Background Psychiatric outpatients with a refugee background have often been exposed to a variety of potentially traumatizing events, with numerous negative consequences for their mental health and quality of life. However, some patients also report positive personal changes, posttraumatic growth, related to these potentially traumatic events. This study describes posttraumatic growth, posttraumatic stress symptoms, depressive symptoms, post-migration stressors, and their association with quality of life in an outpatient psychiatric population with a refugee background in Norway. Methods Fifty five psychiatric outpatients with a refugee background participated in a cross-sectional study using clinical interviews to measure psychopathology (SCID-PTSD, MINI), and four self-report instruments measuring posttraumatic growth, posttraumatic stress symptoms, depressive symptoms, and quality of life (PTGI-SF, IES-R, HSCL-25-depression scale, and WHOQOL-Bref) as well as measures of social integration, social network and employment status. Results All patients reported some degree of posttraumatic growth, while only 31% reported greater amounts of growth. Eighty percent of the patients had posttraumatic stress symptoms above the cut-off point, and 93% reported clinical levels of depressive symptoms. Quality of life in the four domains of the WHOQOL-Bref levels were low, well below the threshold for the’life satisfaction’ standard proposed by Cummins. A hierarchic regression model including depressive symptoms, posttraumatic stress symptoms, posttraumatic growth, and unemployment explained 56% of the total variance found in the psychological health domain of the WHOQOL-Bref scale. Posttraumatic growth made the strongest contribution to the model, greater than posttraumatic stress symptoms or depressive symptoms. Post-migration stressors like unemployment, weak social network and poor social integration were moderately negatively correlated with posttraumatic growth and
Gao, Wen; Zhao, Jing; Li, Yang; Cao, Feng-Lin
To explore the roles of attachment and alexithymia in the severity of post-traumatic stress disorder symptoms and to specify the relationship between sub-dimensions of attachment, alexithymia and posttraumatic stress disorder symptoms in patients with first-time myocardial infarction in mainland China. Patients experiencing myocardial infarction have a risk of developing post-traumatic stress disorder symptoms. However, there have been few studies on the roles of attachment and alexithymia. A cross-sectional survey design. Ninety-seven patients participated in the assessment of post-traumatic stress disorder symptoms, attachment and alexithymia from June-December in 2012. To assess post-traumatic stress disorder symptoms and their correlates, we administered the Post-traumatic Stress Disorder Checklist-Civilian Version, the 20-item Toronto Alexithymia Scale and the Experiences in Close Relationships Scale 5-17 days after the remission of first myocardial infarction attack. Twenty-five (25·77%) patients met the criteria of posttraumatic stress disorder symptoms. Greater attachment anxiety and avoidance were associated with more severe posttraumatic stress disorder symptoms. Except for externally oriented thinking, all dimensions of alexithymia were significantly correlated with post-traumatic stress symptoms. In the regression model, attachment anxiety and difficulties identifying feelings were found to be predictive and the total regression equation explained 24·2% variance of posttraumatic stress disorder symptoms among myocardial infarction patients. First-time myocardial infarction patients were at risk of developing posttraumatic stress disorder symptoms. Attachment anxiety and difficulties identifying feelings were positively associated with posttraumatic stress disorder symptoms in the early stage of myocardial infarction rehabilitation. It is essential to evaluate the causal relationship between attachment, alexithymia and posttraumatic stress disorder
Häuser, Winfried; Galek, Alexandra; Erbslöh-Möller, Brigitte; Köllner, Volker; Kühn-Becker, Hedi; Langhorst, Jost; Petermann, Franz; Prothmann, Ulrich; Winkelmann, Andreas; Schmutzer, Gabriele; Brähler, Elmar; Glaesmer, Heide
A link between fibromyalgia syndrome (FMS) and posttraumatic stress disorder (PTSD) has been suggested because both conditions share some similar symptoms. The temporal relationships between traumatic experiences and the onset of PTSD and FMS symptoms have not been studied until now. All consecutive FMS patients in 8 study centres of different specialties were assessed from February 1 to July 31, 2012. Data on duration of chronic widespread pain (CWP) were based on patients' self-reports. Potential traumatic experiences and year of most burdensome traumatic experience were assessed by the trauma list of the Munich Composite International Diagnostic Interview. PTSD was diagnosed according to the Diagnostic and Statistical Manual of Mental Disorders IV symptom criteria by the Posttraumatic Diagnostic Scale. Age- and sex-matched persons of a general population sample were selected for controls. Three hundred ninety-five of 529 patients screened for eligibility were analysed (93.9% women, mean age 52.3 years, mean duration since chronic widespread pain 12.8 years); 45.3% of FMS patients and 3.0% of population controls met the criteria for PTSD. Most burdensome traumatic experience and PTSD symptoms antedated the onset of CWP in 66.5% of patients. In 29.5% of patients, most burdensome traumatic experience and PTSD symptoms followed the onset of CWP. In 4.0% of patients' most burdensome traumatic experience, PTSD and FMS symptoms occurred in the same year. FMS and PTSD are linked in several ways: PTSD is a potential risk factor of FMS and vice versa. FMS and PTSD are comorbid conditions because they are associated with common antecedent traumatic experiences. Copyright © 2013 International Association for the Study of Pain. Published by Elsevier B.V. All rights reserved.
Hunkin, Victoria; Chung, Man Cheung
The objective of this study was to investigate the interrelationship between chronic idiopathic urticaria (CIU), psychological co-morbidity, posttraumatic stress, repression and alexithymia. 89 participants with CIU and 105 without CIU responded to an online questionnaire. Both groups completed the general health questionnaire-12, the perceived stress scale, the posttraumatic stress diagnostic scale and the Toronto alexithymia scale-20 and were categorised into four defence mechanism groups (repressive, defensive, high-anxious, low-anxious). CIU participants also completed the Skindex-17 and a self-report severity measure. CIU participants reported higher levels of alexithymia than the control group and their defence mechanism was most likely to be categorised as defensive, with conscious self-image management reported alongside high manifest anxiety. Partial least squares analysis revealed significant paths between posttraumatic stress and CIU severity and psychological co-morbidity. Posttraumatic stress was associated with alexithymia and type of defence mechanism. Only being in the high-anxious group partially mediated the relationship between posttraumatic stress and CIU severity. In conclusion, there is evidence for a relationship between CIU and trauma. The severity of posttraumatic symptoms varies depending upon alexithymic traits and defence mechanisms used. Disease severity and psychological co-morbidity are differentially influenced by the relationships between trauma, alexithymic traits and defence mechanisms.
Full Text Available Background/Aim. Comorbidity of the posttraumatic stress disorder (PTSD and depression is often recognized in the clinical practice. The aim of the paper was to determine the severity of depression and the group of symptoms which are the most prominent in clinical depression comorbid with PTSD. Methods. Totally 60 patients were assessed and divided into the experimental and control group using the Structured Clinical Interview for DSM-IV Axis I Disorders, Investigator Version (SCID-I, modified (SCID for DSM-IV and ICD-10 diagnostic criteria. The presence and the severity of the disorders were assessed by means of the following instruments: Clinician-Administrated PTSD Scale for DSM-IV (CAPS-DX, Montgomery-Asberg Depression Rating Scale (MADRS and 17-item Hamilton Rating Scale for Depression (HAMD. The differences between groups were evaluated using Student t test and by means of the correlation analysis of the data with p < 0.05. Results. The obtained results showed that depression witch was comorbid with PTSD was of significant clinical severity with 31.20 score on HAMD and 30.43 score on MADRS in PTSD-D group. The group of the symptoms: lassitude, inability to feel, suicidal thoughts and inner tension contributed mostly to the global severity of the comorbid clinical depression on MADRS. The group of the symptoms: suicide and somatic symptoms, gastrointestinal, guilt, hypochondriasis, work and activity, anxiety psychic, agitation, and weight loss, genital symptoms and anxiety somatic contributed mostly to the global severity of comorbid clinical depression on HAMD. The average score was 16.03 and 16.97 on HAMD and MADRS, respectively in PTSD group. Conclusion. Depression which is comorbid with posttraumatic stress disorder represents significant clinical entity with domination of the different groups of symptoms between the groups PTSD and PTSD-D on HAMD. Identification of aforementioned severity of illness and delineated group of symptoms lead
Full Text Available Thad E Abrams,1,2 Amy Blevins,1,3 Mark W Vander Weg1,2,4 1Department of Internal Medicine, University of Iowa, 2Center for Comprehensive Access and Delivery Research and Evaluation, Iowa City VA Health Care System, 3Hardin Health Sciences Library, 4Department of Psychological and Brain Sciences, University of Iowa, Iowa City, IA, USA Background: Several studies have reported on the co-occurrence of chronic obstructive pulmonary disease (COPD and psychiatric conditions, with the most robust evidence base demonstrating an impact of comorbid anxiety and depression on COPD-related outcomes. In recent years, research has sought to determine if there is a co-occurrence between COPD and posttraumatic stress disorder (PTSD as well as for associations between PTSD and COPD-related outcomes. To date, there have been no published reviews summarizing this emerging literature.Objectives: The primary objective of this review was to determine if there is adequate evidence to support a co-occurrence between PTSD and COPD. Secondary objectives were to: 1 determine if there are important clinical considerations regarding the impact of PTSD on COPD management, and 2 identify targeted areas for further research.Methods: A structured review was performed using a systematic search strategy limited to studies in English, addressing adults, and to articles that examined: 1 the co-occurrence of COPD and PTSD and 2 the impact of PTSD on COPD-related outcomes. To be included, articles must have addressed some type of nonreversible obstructive lung pathology.Results: A total of 598 articles were identified for initial review. Upon applying the inclusion and exclusion criteria, n=19 articles or abstracts addressed our stated objectives. Overall, there is inconclusive evidence to support the co-occurrence between PTSD and COPD. Studies finding a significant co-occurrence generally had inferior methods of identifying COPD; in contrast, studies that utilized more robust COPD
Full Text Available Emotional Stroop task (EST has been extensively used to investigate attentional processes in posttraumatic stress disorder (PTSD. Even though aging significantly changes the dynamics of emotion-cognition interactions, very little is known about its role in shaping EST performance in PTSD patients. In the present study we tested a uniquely large sample of motor vehicle accident victims. Data of 194 participants (75.3% female; mean age = 36.64 years, SD = 12.3 were included in the analysis, out of which 136 (70.1% were diagnosed with PTSD. Prior to the psychiatric assessment, participants completed the pictorial version of EST (neutral, positive, negative, and accidents photos were presented. Comparison of the PTSD and control groups revealed a specific increase in reaction times (RTs related to the exposure of trauma-related material. At the same time, previously unreported, moderating effects of age were also discovered. Older participants, in contrast to the younger group, showed no increase in RTs and interference scores in trials where accident photos were presented. Our study points to the key role of age as a previously understudied factor modifying EST performance in PTSD patients.
Roberts, Andrea L; Rosario, Margaret; Corliss, Heather L; Koenen, Karestan C; Austin, S Bryn
We examined whether lifetime risk of posttraumatic stress disorder (PTSD) was elevated in sexual minority versus heterosexual youths, whether childhood abuse accounted for disparities in PTSD, and whether childhood gender nonconformity explained sexual-orientation disparities in abuse and subsequent PTSD. We used data from a population-based study (n=9369, mean age=22.7 years) to estimate risk ratios for PTSD. We calculated the percentage of PTSD disparities by sexual orientation accounted for by childhood abuse and gender nonconformity, and the percentage of abuse disparities by sexual orientation accounted for by gender nonconformity. Sexual minorities had between 1.6 and 3.9 times greater risk of probable PTSD than heterosexuals. Child abuse victimization disparities accounted for one third to one half of PTSD disparities by sexual orientation. Higher prevalence of gender nonconformity before age 11 years partly accounted for higher prevalence of abuse exposure before age 11 years and PTSD by early adulthood in sexual minorities (range=5.2%-33.2%). Clinicians, teachers, and others who work with youths should consider abuse prevention and treatment measures for gender-nonconforming children and sexual minority youths.
Roberts, Andrea L; Austin, S Bryn; Corliss, Heather L; Vandermorris, Ashley K; Koenen, Karestan C
We assessed sexual orientation disparities in exposure to violence and other potentially traumatic events and onset of posttraumatic stress disorder (PTSD) in a representative US sample. We used data from 34 653 noninstitutionalized adult US residents from the 2004 to 2005 wave of the National Epidemiologic Survey on Alcohol and Related Conditions. Lesbians and gay men, bisexuals, and heterosexuals who reported any same-sex sexual partners over their lifetime had greater risk of childhood maltreatment, interpersonal violence, trauma to a close friend or relative, and unexpected death of someone close than did heterosexuals with no same-sex attractions or partners. Risk of onset of PTSD was higher among lesbians and gays (adjusted odds ratio [AOR] = 2.03; 95% confidence interval [CI] = 1.34, 3.06), bisexuals (AOR = 2.13; 95% CI = 1.38, 3.29), and heterosexuals with any same-sex partners (AOR = 2.06; 95% CI = 1.54, 2.74) than it was among the heterosexual reference group. This higher risk was largely accounted for by sexual orientation minorities' greater exposure to violence, exposure to more potentially traumatic events, and earlier age of trauma exposure. Profound sexual orientation disparities exist in risk of PTSD and in violence exposure, beginning in childhood. Our findings suggest there is an urgent need for public health interventions aimed at preventing violence against individuals with minority sexual orientations and providing follow-up care to cope with the sequelae of violent victimization.
Rosario, Margaret; Corliss, Heather L.; Koenen, Karestan C.; Austin, S. Bryn
OBJECTIVES: Childhood gender nonconformity has been associated with poorer relationships with parents, but it is unknown if childhood gender nonconformity is associated with childhood abuse or risk of posttraumatic stress disorder (PTSD) in youth. METHODS: We examined whether gender nonconformity before age 11 years was associated with childhood sexual, physical, and psychological abuse and lifetime risk of probable PTSD by using self-report questionnaire data from the 2007 wave of the Growing Up Today Study (n = 9864, mean age = 22.7 years), a longitudinal cohort of US youth. We further examined whether higher exposure to childhood abuse mediated possible elevated prevalence of PTSD in nonconforming children. Finally, we examined whether association of childhood gender nonconformity with PTSD was independent of sexual orientation. RESULTS: Exposure to childhood physical, psychological, and sexual abuse, and probable PTSD were elevated in youth in the top decile of childhood gender nonconformity compared with youth below median nonconformity. Abuse victimization disparities partly mediated PTSD disparities by gender nonconformity. Gender nonconformity predicted increased risk of lifetime probable PTSD in youth after adjustment for sexual orientation. CONCLUSIONS: We identify gender nonconformity as an indicator of children at increased risk of abuse and probable PTSD. Pediatricians and school health providers should consider abuse screening for this vulnerable population. Further research to understand how gender nonconformity might increase risk of abuse and to develop family interventions to reduce abuse risk is needed. PMID:22351893
Roberts, Andrea L; Rosario, Margaret; Corliss, Heather L; Koenen, Karestan C; Austin, S Bryn
Childhood gender nonconformity has been associated with poorer relationships with parents, but it is unknown if childhood gender nonconformity is associated with childhood abuse or risk of posttraumatic stress disorder (PTSD) in youth. We examined whether gender nonconformity before age 11 years was associated with childhood sexual, physical, and psychological abuse and lifetime risk of probable PTSD by using self-report questionnaire data from the 2007 wave of the Growing Up Today Study (n = 9864, mean age = 22.7 years), a longitudinal cohort of US youth. We further examined whether higher exposure to childhood abuse mediated possible elevated prevalence of PTSD in nonconforming children. Finally, we examined whether association of childhood gender nonconformity with PTSD was independent of sexual orientation. Exposure to childhood physical, psychological, and sexual abuse, and probable PTSD were elevated in youth in the top decile of childhood gender nonconformity compared with youth below median nonconformity. Abuse victimization disparities partly mediated PTSD disparities by gender nonconformity. Gender nonconformity predicted increased risk of lifetime probable PTSD in youth after adjustment for sexual orientation. We identify gender nonconformity as an indicator of children at increased risk of abuse and probable PTSD. Pediatricians and school health providers should consider abuse screening for this vulnerable population. Further research to understand how gender nonconformity might increase risk of abuse and to develop family interventions to reduce abuse risk is needed.
Full Text Available Abnormal corpus callosum (CC has been reported in childhood trauma-related posttraumatic stress disorder (PTSD; however, the nature of white matter (WM integrity alterations in the CC of young adult-onset PTSD patients is unknown. In this study, 14 victims of a coal mine gas explosion with PTSD and 23 matched coal miners without experiencing the coal mine explosion were enrolled. The differences in fractional anisotropy (FA within 7 sub-regions of the CC were compared between the two groups. Compared to the controls, PTSD coal miners exhibited significantly reduced FA values in the anterior sub-regions of the CC (P < 0.05, Bonferroni-corrected, which mainly interconnect the bilateral frontal cortices. Our findings indicated that the anterior part of the CC was more severely impaired than the posterior part in young adult-onset PTSD, which suggested the patterns of CC impairment may depend on the developmental stage of the structure when the PTSD occurs.
Full Text Available The cumulative exposure to life-threatening events increases the risk for posttraumatic stress disorder (PTSD. However, over the course of evolutionary adaptation, intra-species killing may have also evolved as an inborn strategy leading to greater reproductive success. Assuming that homicide has evolved as a profitable strategy in humans, a protective mechanism must prevent the perpetrator from getting traumatised by self-initiated violent acts. We thus postulate an inverse relation between a person's propensity toward violence and PTSD. We surveyed a sample of 269 Rwandan prisoners who were accused or convicted for crimes related to the 1994 genocide. In structured interviews we assessed traumatic event types, types of crimes committed, the person's appetitive violence experience with the Appetitive Aggression Scale (AAS and PTSD symptom severity with the PSS-I. Using path-analysis, we found a dose-response effect between the exposure to traumatic events and the PTSD symptom severity (PSS-I. Moreover, participants who had reported that they committed more types of crimes demonstrated a higher AAS score. In turn, higher AAS scores predicted lower PTSD symptom severity scores. This study provides first empirical support that the victim's struggling can be an essential rewarding cue for perpetrators. The results also suggest that an appetitive aggression can inhibit PTSD and trauma-related symptoms in perpetrators and prevent perpetrators from getting traumatised by their own atrocities.
Weierstall, Roland; Schaal, Susanne; Schalinski, Inga; Dusingizemungu, Jean-Pierre; Elbert, Thomas
The cumulative exposure to life-threatening events increases the risk for posttraumatic stress disorder (PTSD). However, over the course of evolutionary adaptation, intra-species killing may have also evolved as an inborn strategy leading to greater reproductive success. Assuming that homicide has evolved as a profitable strategy in humans, a protective mechanism must prevent the perpetrator from getting traumatised by self-initiated violent acts. We thus postulate an inverse relation between a person's propensity toward violence and PTSD. We surveyed a sample of 269 Rwandan prisoners who were accused or convicted for crimes related to the 1994 genocide. In structured interviews we assessed traumatic event types, types of crimes committed, the person's appetitive violence experience with the Appetitive Aggression Scale (AAS) and PTSD symptom severity with the PSS-I. Using path-analysis, we found a dose-response effect between the exposure to traumatic events and the PTSD symptom severity (PSS-I). Moreover, participants who had reported that they committed more types of crimes demonstrated a higher AAS score. In turn, higher AAS scores predicted lower PTSD symptom severity scores. This study provides first empirical support that the victim's struggling can be an essential rewarding cue for perpetrators. The results also suggest that an appetitive aggression can inhibit PTSD and trauma-related symptoms in perpetrators and prevent perpetrators from getting traumatised by their own atrocities.
Main Sources of Occupational Stress and Symptoms of Burnout, Clinical Distress, and Post-Traumatic Stress Among Distributed Common Ground System Intelligence Exploitation Operators (2011 USAFSAM Survey Results)
AFRL-SA-WP-TR-2012-0010 Main Sources of Occupational Stress and Symptoms of Burnout , Clinical Distress, and Post-Traumatic Stress Among...of Occupational Stress and Symptoms of Burnout , Clinical Distress, and Post-Traumatic Stress Among Distributed Common Ground System Intelligence...occupational burnout , clinical distress, post-traumatic stress disorder, as well as vicarious exposure to combat. The results of the study suggest
In practice it is not unusual for client-centred therapists to work with people who have experienced traumatic events. However, client-centred therapy is not usually considered within texts on traumatic stress and questions have been raised over the appropriateness of client-centred therapy with trauma survivors. The present study shows how, although he was writing well before the introduction of the term 'post-traumatic stress disorder', Carl Rogers provided a theory of therapy and personality that contains an account of threat-related psychological processes largely consistent with contemporary trauma theory. Rogers' theory provides the conceptual underpinnings to the client-centred and experiential ways of working with traumatized people. Furthermore, Rogers' theory provides an understanding of post-traumatic growth processes, and encourages therapists to adopt a more positive psychological perspective to their understanding of how people adjust to traumatic events.
Logue, Mark W; Amstadter, Ananda B; Baker, Dewleen G; Duncan, Laramie; Koenen, Karestan C; Liberzon, Israel; Miller, Mark W; Morey, Rajendra A; Nievergelt, Caroline M; Ressler, Kerry J; Smith, Alicia K; Smoller, Jordan W; Stein, Murray B; Sumner, Jennifer A; Uddin, Monica
The development of posttraumatic stress disorder (PTSD) is influenced by genetic factors. Although there have been some replicated candidates, the identification of risk variants for PTSD has lagged behind genetic research of other psychiatric disorders such as schizophrenia, autism, and bipolar disorder. Psychiatric genetics has moved beyond examination of specific candidate genes in favor of the genome-wide association study (GWAS) strategy of very large numbers of samples, which allows for the discovery of previously unsuspected genes and molecular pathways. The successes of genetic studies of schizophrenia and bipolar disorder have been aided by the formation of a large-scale GWAS consortium: the Psychiatric Genomics Consortium (PGC). In contrast, only a handful of GWAS of PTSD have appeared in the literature to date. Here we describe the formation of a group dedicated to large-scale study of PTSD genetics: the PGC-PTSD. The PGC-PTSD faces challenges related to the contingency on trauma exposure and the large degree of ancestral genetic diversity within and across participating studies. Using the PGC analysis pipeline supplemented by analyses tailored to address these challenges, we anticipate that our first large-scale GWAS of PTSD will comprise over 10 000 cases and 30 000 trauma-exposed controls. Following in the footsteps of our PGC forerunners, this collaboration-of a scope that is unprecedented in the field of traumatic stress-will lead the search for replicable genetic associations and new insights into the biological underpinnings of PTSD.
Kraaij, Vivian; Arensman, Ella; Garnefski, Nadia; Kremers, Ismay
The aim of the study is to examine the role of cognitive coping in a sample of 47 female victims of stalking. Stalking victims who blamed themselves more for the stalking report significantly higher symptoms of depression, anxiety, and posttraumatic stress disorder (PTSD). Respondents who ruminated more about the stalking experience, or…
Shamia, N A; Thabet, A A M; Vostanis, P
What is known on the subject? This study builds on existing research on war-related factors that may affect health-care staff by particularly focusing on trauma exposure in both professional and everyday life, as well as on correlates of later positive psychological changes. What this paper adds to existing knowledge? It shows that one in five nursing staff working in Gaza experienced post-traumatic stress symptoms within the clinical range, 2 years after an incursion on Gaza and after being exposed to substantial trauma during this period. Participants appeared to develop a variety of post-traumatic growth responses following trauma exposure. Although nurses experienced traumatic events both as civilians and in their health-care capacity, personal exposure was strongly associated with PTSD symptoms. What are the implications for practice? Support to nursing and other health-care professionals in war situations should entail different levels, remain available well after an acute conflict, and take into consideration both personal and practice-related traumatic events. Mental health nursing practitioners can play a pivotal role in this. To establish the association between war traumatic experiences, post-traumatic stress disorder (PTSD) symptoms and post-traumatic growth among nurses in the Gaza Strip, 2 years after an incursion on Gaza, and during a period of ongoing trauma exposure. This study builds on existing evidence by considering exposure to personal and work-related traumatic events, and on factors associated with later positive psychological adaptation. The sample consisted of 274 randomly selected nurses in Gaza who completed the Gaza Traumatic Events Checklist, PTSD Checklist, and Posttraumatic Growth Inventory. Of the nurses, 19.7% reported full PTSD. There was a significant relationship between traumatic events and PTSD scores; as well as between community-related traumatic events and post-traumatic growth. Participants reported a range of traumatic
Ayse Nuray Karanci
Full Text Available Background: Posttraumatic growth (PTG is conceptualized as a positive transformation resulting from coping with and processing traumatic life events. This study examined the contributory roles of personality traits, posttraumatic stress (PTS severity and their interactions on PTG and its domains, as assessed with the Posttraumatic Growth Inventory Turkish form (PTGI-T. The study also examined the differences in PTG domains between survivors of accidents, natural disasters and unexpected loss of a loved one. Methods: The Basic Personality Traits Inventory, Posttraumatic Diagnostic Scale, and PTGI-T were administered to a large stratified cluster community sample of 969 Turkish adults in their home settings. Results: The results showed that conscientiousness, agreeableness, and openness to experience significantly related to the total PTG and most of the domains. The effects of extraversion, neuroticism and openness to experience were moderated by the PTS severity for some domains. PTG in relating to others and appreciation of life domains was lower for the bereaved group. Conclusion: Further research should examine the mediating role of coping between personality and PTG using a longitudinal design.
van Emmerik, Arnold A P; Reijntjes, Albert; Kamphuis, Jan H
Face-to-face psychological treatments have difficulty meeting today's growing mental health needs. For the highly prevalent posttraumatic stress (PTS) conditions, accumulating evidence suggests that writing therapy may constitute an efficient treatment modality, especially when administered through the Internet. We therefore conducted a meta-analysis to investigate the efficacy of writing therapies for PTS and comorbid depressive symptoms. The literature was searched using several structured and unstructured strategies, including key word searches of the PubMed, Web of Science, PsycINFO, and PILOTS databases. Six studies met eligibility criteria and were included in the analyses. These studies included a total of 633 participants, of which 304 were assigned to writing therapy. Across 5 direct comparisons of writing therapy to waiting-list control, writing therapy resulted in significant and substantial short-term reductions in PTS and comorbid depressive symptoms. There was no difference in efficacy between writing therapy and trauma-focused cognitive behavioral therapy, but we caution that this finding was based on only 2 direct comparisons. Writing therapy is an evidence-based treatment for PTS, and constitutes a useful treatment alternative for patients who do not respond to other evidence-based treatments. Internet adaptations of writing therapy for PTS may be especially useful for reaching trauma survivors in need of evidence-based mental health care who live in remote areas or who prefer to retain their anonymity. Copyright © 2012 S. Karger AG, Basel.
Tipps, Megan E; Raybuck, Jonathan D; Lattal, K Matthew
A large body of literature demonstrates the effects of abused substances on memory. These effects differ depending on the drug, the pattern of delivery (acute or chronic), and the drug state at the time of learning or assessment. Substance use disorders involving these drugs are often comorbid with anxiety disorders, such as post-traumatic stress disorder (PTSD). When the cognitive effects of these drugs are considered in the context of the treatment of these disorders, it becomes clear that these drugs may play a deleterious role in the development, maintenance, and treatment of PTSD. In this review, we examine the literature evaluating the cognitive effects of three commonly abused drugs: nicotine, cocaine, and alcohol. These three drugs operate through both common and distinct neurobiological mechanisms and alter learning and memory in multiple ways. We consider how the cognitive and affective effects of these drugs interact with the acquisition, consolidation, and extinction of learned fear, and we discuss the potential impediments that substance abuse creates for the treatment of PTSD. Copyright © 2013 Elsevier Inc. All rights reserved.
Gentes, Emily; Dennis, Paul A.; Kimbrel, Nathan A.; Kirby, Angela C.; Hair, Lauren P.; Beckham, Jean C.; Calhoun, Patrick S.
The current study examined the latent factor structure of posttraumatic stress disorder (PTSD) based on DSM-5 criteria in a sample of participants (N = 374) recruited for studies on trauma and health. Confirmatory factor analyses (CFA) were used to compare the fit of the previous 3-factor DSM-IV model of PTSD to the 4-factor model specified in DSM-5 as well as to a competing 4-factor “dysphoria” model (Simms, Watson, & Doebbeling, 2002) and a 5-factor (Elhai et al., 2011) model of PTSD. Results indicated that the Elhai 5-factor model (re-experiencing, active avoidance, emotional numbing, dysphoric arousal, anxious arousal) provided the best fit to the data, although substantial support was demonstrated for the DSM-5 4-factor model. Low factor loadings were noted for two of the symptoms in the DSM-5 model (psychogenic amnesia and reckless/self-destructive behavior), which raises questions regarding the adequacy of fit of these symptoms with other core features of the disorder. Overall, the findings from the present research suggest the DSM-5 model of PTSD is a significant improvement over the previous DSM-IV model of PTSD. PMID:26366290
Full Text Available OBJECTIVE: To explore the neural mechanisms of negative emotion regulation in patients with post-traumatic stress disorder (PTSD. METHODS: Twenty PTSD patients and 20 healthy subjects were recruited. Event-related functional magnetic resonance imaging (fMRI was used to investigate the modification of emotional responses to negative stimuli. Participants were required to regulate their emotional reactions according to the auditory regulation instructions via headphones, to maintain, enhance or diminish responses to negative stimuli during fMRI scans. RESULTS: The PTSD group showed poorer modification performance than the control group when diminishing responses to negative stimuli. On fMRI, the PTSD group showed decreased activation in the inferior frontal cortex, inferior parietal lobule, insula and putamen, and increased activation in posterior cingulate cortex and amygdala during up-regulation of negative emotion. Similar decreased activation regions were found during down-regulation of negative emotion, but no increased activation was found. CONCLUSION: Trauma exposure might impair the ability to down-regulate negative emotion. The present findings will improve our understanding of the neural mechanisms of emotion regulation underlying PTSD.
Neria, Y; Nandi, A; Galea, S
Disasters are traumatic events that may result in a wide range of mental and physical health consequences. Post-traumatic stress disorder (PTSD) is probably the most commonly studied post-disaster psychiatric disorder. This review aimed to systematically assess the evidence about PTSD following exposure to disasters. MethodA systematic search was performed. Eligible studies for this review included reports based on the DSM criteria of PTSD symptoms. The time-frame for inclusion of reports in this review is from 1980 (when PTSD was first introduced in DSM-III) and February 2007 when the literature search for this examination was terminated. We identified 284 reports of PTSD following disasters published in peer-reviewed journals since 1980. We categorized them according to the following classification: (1) human-made disasters (n=90), (2) technological disasters (n=65), and (3) natural disasters (n=116). Since some studies reported on findings from mixed samples (e.g. survivors of flooding and chemical contamination) we grouped these studies together (n=13). The body of research conducted after disasters in the past three decades suggests that the burden of PTSD among persons exposed to disasters is substantial. Post-disaster PTSD is associated with a range of correlates including sociodemographic and background factors, event exposure characteristics, social support factors and personality traits. Relatively few studies have employed longitudinal assessments enabling documentation of the course of PTSD. Methodological limitations and future directions for research in this field are discussed.
Engdahl, B.; Leuthold, A. C.; Tan, H.-R. M.; Lewis, S. M.; Winskowski, A. M.; Dikel, T. N.; Georgopoulos, A. P.
In a recent paper (Georgopoulos et al 2010 J. Neural Eng. 7 016011) we reported on the power of the magnetoencephalography (MEG)-based synchronous neural interactions (SNI) test to differentiate post-traumatic stress disorder (PTSD) subjects from healthy control subjects and to classify them with a high degree of accuracy. Here we show that the main differences in cortical communication circuitry between these two groups lie in the miscommunication of temporal and parietal and/or parieto-occipital right hemispheric areas with other brain areas. This lateralized temporal-posterior pattern of miscommunication was very similar but was attenuated in patients with PTSD in remission. These findings are consistent with observations (Penfield 1958 Proc. Natl Acad. Sci. USA 44 51-66, Penfield and Perot 1963 Brain 86 595-696, Gloor 1990 Brain 113 1673-94, Banceaud et al 1994 Brain 117 71-90, Fried 1997 J. Neuropsychiatry Clin. Neurosci. 9 420-8) that electrical stimulation of the temporal cortex in awake human subjects, mostly in the right hemisphere, can elicit the re-enactment and re-living of past experiences. Based on these facts, we attribute our findings to the re-experiencing component of PTSD and hypothesize that it reflects an involuntarily persistent activation of interacting neural networks involved in experiential consolidation.
Full Text Available Introduction. Long-term psychological consequences of critical illness are receiving more attention in recent years. The aim of our study was to assess the correlation of ICU-delirium and symptoms of posttraumatic stress disorder (PTSD anxiety and depression after ICU-discharge in a Danish cohort. Methods. A prospective observational cohort study assessing the incidence of delirium in the ICU. Psychometrics were screened by validated tools in structured telephone interviews after 2 months (n=297 and 6 months (n=248 after ICU-discharge. Results. Delirium was detected in 54% of patients in the ICU and symptoms of PTSD in 8% (2 months and 6% (6 months after ICU-discharge. Recall of ICU stay was present in 93%. Associations between ICU-delirium and post-discharge PTSD-symptoms were weak and insignificant. Memories of delusions were significantly associated with anxiety after two months. Remaining associations between types of ICU-memories and prevalence of post-discharge symptoms of PTSD, anxiety, and depression were insignificant after adjusting for age. Incidence of ICU-delirium was unaffected by preadmission use of psychotropic drugs. Prevalence of PTSD-symptoms was unaffected by use of antipsychotics and sedation in the ICU. Conclusion. ICU-delirium did not increase the risk of PTSD-symptoms at 2 and 6 months after ICU discharge.
Vilija, Malinauskiene; Romualdas, Malinauskas
The linkage between mood states and unhealthy food consumption has been under investigation in the recent years. This study aimed to evaluate the associations between posttraumatic stress (PTS) symptoms after lifetime traumatic experiences and daily unhealthy food consumption among adolescents, taking into account the possible effects of physical inactivity, smoking, and a sense of coherence. A self-administered questionnaire measured symptoms of PTS, lifetime traumatic experiences, food frequency scale, sense of coherence scale in a representative sample of eighth grade pupils of the Kaunas, Lithuania, secondary schools (N=1747; 49.3% girls and 50.7% boys). In the logistic regression models, all lifetime traumatic events were associated with PTS symptoms, as well as were unhealthy foods, (including light alcoholic drinks, spirits, soft and energy drinks, flavored milk, coffee, fast food, chips and salty snacks, frozen processed foods; excluding sweet snacks, biscuits and pastries) and sense of coherence weakened the strength of the associations. However, physical inactivity and smoking showed no mediating effect for the majority of unhealthy foods. In conclusion, we found that intervention and preventive programs on PTS symptoms may be beneficial while dealing with behavioral problems (unhealthy diet, smoking, alcohol, physical inactivity) among adolescents. Copyright © 2013 Elsevier Ltd. All rights reserved.
Full Text Available Posttraumatic stress disorder (PTSD can develop in some individuals who are exposed to an event that causes extreme fear, horror, or helplessness (APA, 1994. PTSD is a complex and heterogeneous disorder, which is often co-morbid with depression, substance abuse, and anxiety disorders such as panic or social phobia. Given this complexity, progress in the field can be greatly enhanced by focusing on phenotypes that are more proximal to the neurobiology of the disorder. Such neurobiological intermediate phenotypes can provide investigative tools to increase our understanding of the roots of the disorder and develop better prevention or intervention programs. In the present paper, we argue that the inhibition of fear responses is an intermediate phenotype that is related to both the neurocircuitry associated with the disorder, and is linked to its clinical symptoms. An advantage of focusing on fear inhibition is that the neurobiology of fear has been well investigated in animal models providing the necessary groundwork in understanding alterations. Furthermore, because many paradigms can be tested across species, fear inhibition is an ideal translational tool. Here we review both the behavioral tests and measures of fear inhibition and the related neurocircuitry in neuroimaging studies with both healthy and clinical samples.
Mystakidou, K; Parpa, E; Tsilika, E; Panagiotou, I; Galanos, A; Sakkas, P; Gouliamos, A
The purpose of the current study was to investigate the prevalence of posttraumatic stress disorder (PTSD) and its association with sociodemographic variables and preparatory grief in patients with advanced cancer. 195 advanced cancer patients participated in the study. Out of them, 170 had PTSD and 25 had other anxiety disorders. The diagnoses were made in strict accordance with Structured Clinical Interview for DSM-IV Axis I disorders (SCID-I)-Clinician version. Patients completed also the Preparatory Grief in Advanced Cancer Patients (PGAC) scale. Patients with PTSD were younger (63.54 ± 12.07 years) than those without PTSD (70.36 ± 13.03 years, p=0.010). Patients with PTSD revealed more preparatory grief (37.69 ± 12.11) than those without PTSD (29.58 ± 14.04, p= 0.003). Multiple logistic regression analysis showed that preparatory grief (p=0.012), and metastatic disease (p=0.009) remained in the model whereas age showed a trend for independent significance (p=0.067). In advanced cancer stages, younger patients, those with metastatic disease or patients with elevated scores on preparatory grief seemed to have a greater likelihood to develop PTSD. Thus, given the prevalence of PTSD in advanced cancer patients, health care professionals should be able to better recognize those who are at risk for or exhibit symptoms of this disorder so that appropriate treatment referrals can be made.
Rogal, Shari S; Poschman, Karalee; Belanger, Kathleen; Howell, Heather B; Smith, Megan V; Medina, Jessica; Yonkers, Kimberly A
The purpose of this study was to determine the association between posttraumatic stress disorder (PTSD), diagnosed prospectively during pregnancy, and the risk of delivering a low birth weight (infant. Pregnant women were recruited from obstetrics clinics and screened for major and minor depressive disorder, panic disorder, PTSD, and substance use. Current episodes of PTSD were diagnosed according to the MINI International Neuropsychiatric Interview, and pregnancy outcomes were abstracted from hospital records. Among the 1100 women included in analysis, 31 (3%) were in episode for PTSD during pregnancy. Substance use in pregnancy, panic disorder, major and minor depressive disorder, and prior preterm delivery were significantly associated with a diagnosis of PTSD. Preterm delivery was non-significantly higher in pregnant women with (16.1%) compared to those without (7.0%) PTSD (OR=2.82, 95% C.I. 0.95, 8.38). Low birth weight (LBW) was present in 6.5% of women and was not significantly associated with a diagnosis of PTSD in pregnancy after adjusting for potential confounders. However, LBW was significantly associated with minor depressive disorder (OR=1.82, 95% C.I. 1.01, 3.29). There was a low prevalence of PTSD in this cohort, resulting in limited power. These data suggest a possible association between PTSD and preterm delivery. Coupled with the association found between LBW and a depressive disorder, these results support the utility of screening for mental health disorders in pregnancy.
Green, Ben; Griffiths, Emily C
To compare the birth order of patients with post-traumatic stress disorder (PTSD) and adjustment disorder (AD) with population norms. 83 PTSD patients and 104 AD control patients from a psychiatric trauma clinic were diagnosed according to DCR-10 guidelines. A family history was taken as to number of siblings, and their birth order. We compared the distribution of birth order for each patient group against birth order distributions expected by chance for the same years of birth using UK population-level birth order from the Office for National Statistics. Psychiatric patients with PTSD were more likely to be from a large family, specifically to be the fifth child or later (OR 4.78, p birth order between AD patients and the general population. People with PTSD are more likely to be the youngest children from large families than expected from a random sample of people born in the same years. This association with birth order was not found for another psychiatric diagnosis AD from the same clinic. We discuss possible psychosocial and biological causes, and implications for further research.
Cohen, Mardge H; Shi, Qiuhu; Fabri, Mary; Mukanyonga, Henriette; Cai, Xiaotao; Hoover, Donald R; Binagwaho, Agnes; Anastos, Kathryn
Depression and posttraumatic stress disorder (PTSD) are common in developing and postconflict countries. The purpose of this study is to examine longitudinal changes in PTSD in HIV-infected and uninfected Rwandan women who experienced the 1994 genocide. Five hundred thirty-five HIV-positive and 163 HIV-negative Rwandan women in an observational cohort study were followed for 18 months. Data on PTSD symptoms were collected longitudinally by the Harvard Trauma Questionnaire (HTQ) and analyzed in relationship to demographics, HIV status, antiretroviral treatment (ART), and depression. PTSD was defined as a score on the HTQ of ≥2. There was a continuing reduction in HTQ scores at each follow-up visit. The prevalence of PTSD symptoms changed significantly, with 61% of the cohort having PTSD at baseline vs. 24% after 18 months. Women with higher HTQ score were most likely to have improvement in PTSD symptoms (p<0.0001). Higher rate of baseline depressive symptoms (p<0.0001) was associated with less improvement in PTSD symptoms. HIV infection and ART were not found to be consistently related to PTSD improvement. HIV care settings can become an important venue for the identification and treatment of psychiatric problems affecting women with HIV in postconflict and developing countries. Providing opportunities for women with PTSD symptoms to share their history of trauma to trained counselors and addressing depression, poverty, and ongoing violence may contribute to reducing symptoms.
Ravi Philip Rajkumar
Full Text Available Introduction. Various interventions, both psychological and pharmacological, have been studied for their efficacy in preventing posttraumatic stress disorder (PTSD following trauma exposure. However, the preventive effect of pharmacotherapy has not been systematically assessed. Methodology. A systematic review of all clinical trials of drug therapy to prevent PTSD, available through the PubMed and EMBASE databases, was conducted. This included an assessment of each study’s quality. Results. A total of 13 studies were reviewed. The drugs examined in these papers included propranolol, hydrocortisone, serotonin reuptake inhibitors, gabapentin, omega-3 fatty acids, and benzodiazepines. There was marked heterogeneity across studies in terms of quality, study populations, and methodology. Analysis of the outcomes revealed preliminary evidence for the efficacy of hydrocortisone, particularly in critical care settings. There was no consistent evidence to support the use of other drugs to prevent PTSD. Discussion. There may be a limited role for hydrocortisone in preventing the development of PTSD in specific settings. Results with other drugs are inconsistent. Further large-scale studies should assess the efficacy of these approaches in other contexts, such as natural disasters, and the time frame within which they should be used.
Crespo, María; Gómez, M M
The present study aims to analyze diagnostic concordance between the DSM-IV and the DSM-5 for posttraumatic stress disorder (PTSD) diagnostic criteria and their different groups of symptoms. Furthermore, analyses are conducted to establish the features of participants with no concordant diagnoses. The study assessed 166 people over 18 who had experienced at least one traumatic event. PTSD diagnosis was established using the Global Scale for Posttraumatic Stress (EGEP), a self-report measure to assess PTSD. The presence of cognitive avoidance was a determinant in the PTSD DSM-5 diagnosis (86% positive predictive value). The analysis of the non-concordant individuals revealed that individuals who were diagnosed according to the DSM-IV criteria but not the DSM-5 criteria were primarily indirect victims. Conversely, individuals who were diagnosed with the DSM-5 criteria and not with the DSM-IV criteria presented cognitive avoidance and alterations in cognition not included in the DSM-IV criteria. A within-subjects concordance analysis showed high agreement for PTSD diagnosis between the two classifications. Differences between the diagnoses are due to the new definition of C (avoidance) and D (negative alterations in cognitions and mood) in the DSM-5.
Clancy, Kevin; Ding, Mingzhou; Bernat, Edward; Schmidt, Norman B; Li, Wen
Post-traumatic stress disorder is characterized by exaggerated threat response, and theoretical accounts to date have focused on impaired threat processing and dysregulated prefrontal-cortex-amygdala circuitry. Nevertheless, evidence is accruing for broad, threat-neutral sensory hyperactivity in post-traumatic stress disorder. As low-level, sensory processing impacts higher-order operations, such sensory anomalies can contribute to widespread dysfunctions, presenting an additional aetiological mechanism for post-traumatic stress disorder. To elucidate a sensory pathology of post-traumatic stress disorder, we examined intrinsic visual cortical activity (based on posterior alpha oscillations) and bottom-up sensory-driven causal connectivity (Granger causality in the alpha band) during a resting state (eyes open) and a passive, serial picture viewing state. Compared to patients with generalized anxiety disorder (n = 24) and healthy control subjects (n = 20), patients with post-traumatic stress disorder (n = 25) demonstrated intrinsic sensory hyperactivity (suppressed posterior alpha power, source-localized to the visual cortex-cuneus and precuneus) and bottom-up inhibition deficits (reduced posterior→frontal Granger causality). As sensory input increased from resting to passive picture viewing, patients with post-traumatic stress disorder failed to demonstrate alpha adaptation, highlighting a rigid, set mode of sensory hyperactivity. Interestingly, patients with post-traumatic stress disorder also showed heightened frontal processing (augmented frontal gamma power, source-localized to the superior frontal gyrus and dorsal cingulate cortex), accompanied by attenuated top-down inhibition (reduced frontal→posterior causality). Importantly, not only did suppressed alpha power and bottom-up causality correlate with heightened frontal gamma power, they also correlated with increased severity of sensory and executive dysfunctions (i.e. hypervigilance and impulse control
Levrier, Katia; Marchand, Andre; Belleville, Genevieve; Dominic, Beaulieu-Prevost; Guay, Stephane
Up to 71% of trauma victims diagnosed with PTSD have frequent nightmares (NM), compared to only 2% to 5% of the general population. The present study examined whether nightmares before the beginning of cognitive behavior therapy (CBT) for post-traumatic stress disorder (PTSD) could influence overall PTSD symptom reduction for 71 individuals with PTSD and different types of traumatic events. Participants received a validated CBT of 20 weekly individual sessions. They were evaluated at five measurement times: at pre-treatment, after the third and ninth session, at post-treatment, and at 6 months follow-up. The presence of nightmares did not impact overall CBT efficiency. Specific CBT components were efficient in reducing the frequency and distress of nightmares. Most participants no longer had PTSD but some still had nightmares.
Loganovsky, Konstantin N; Zdanevich, Nataliya A
Whether posttraumatic stress disorder (PTSD) following radiation emergency has psychopathological, neurocognitive, and neurophysiological peculiarities is at issue. The goal was to explore the features and cerebral basis of "radiation" PTSD in the survivors of the Chernobyl accident. Subjects and Methods The cross-sectional study included 241 people, 219 of whom have been diagnosed with PTSD according to the Diagnostic and Statistical Manual of Mental Disorders, 4th ed. (DSM-IV) criteria, among them 115 clean-up workers of the Chernobyl accident (34 with acute radiation sickness), 76 evacuees from the Chernobyl exclusion zone, 28 veterans of the war in Afghanistan, and 22 healthy unexposed individuals. Psychometric examinations, neurocognitive assessments, computerized electroencephalography, and cerebral vascular Doppler were used. "Radiation" PTSD includes "flashforward" phenomena and anticipating stress (projection of fear and danger to the future); somatoform disorders (depression, trait and state anxiety); and neurocognitive deficit (impaired memory and attention, auditory-verbal memory and learning, proactive and retroactive interference, cerebellar and stem symptoms, intellectual changes). The intima-media component, thickness of common carotid arteries, and common and left internal carotid arteries stenosis rates are increased in the liquidators. Changes of bioelectrical brain activity as a decrease of beta- and theta-power, together with an increase of alpha-power, were found in the Chernobyl accident survivors with PTSD. PTSD following radiation emergency is characterized by comorbidity of psychopathology, neurocognitive deficit, and cerebrovascular pathology with increased risk of cerebral atherosclerosis and stroke. The cerebral basis of this PTSD is proposed to be an abnormal communication between the pyramidal cells of the neocortex and the hippocampus, and deep brain structures. It is recommended that a system of emergency and long-term psychological
Lee, Yvonne C.; Agnew-Blais, Jessica; Malspeis, Susan; Keyes, Katherine; Costenbader, Karen; Kubzansky, Laura D.; Roberts, Andrea L.; Koenen, Karestan C.; Karlson, Elizabeth W.
Objective To examine the association between symptoms of post-traumatic stress disorder (PTSD) and rheumatoid arthritis (RA) risk in a prospective cohort and to characterize the role of smoking in this relationship. Methods A subset (N = 54,224) of the Nurses’ Health Study II, a prospective cohort of female nurses, completed the Brief Trauma Questionnaire and a screen for PTSD symptoms. Participants were categorized based on trauma exposure and number of PTSD symptoms. Incident RA cases (N = 239) from 1989 to 2011 were identified. Cox proportional hazards models were used to calculate hazard ratios (HRs) and confidence intervals (CIs) between PTSD symptoms and incident RA. To identify the impact of smoking, secondary and subgroup analyses were performed. In all analyses, PTSD and smoking were lagged two years before the development of RA. Results Compared to no history of trauma/PTSD symptoms, the HR for ≥4 PTSD symptoms and incident RA was 1.76 (95% CI 1.16, 2.67) in models adjusted for age, race and socioeconomic status. The risk for RA increased with increasing number of PTSD symptoms (P = 0.01). When smoking was added to the model, the HR for RA remained elevated (HR 1.60; 95% CI 1.05, 2.43). In a subgroup analysis, excluding women who smoked before PTSD onset, results were unchanged (HR 1.68; 95% CI 1.04, 2.70). Conclusion This study suggests that women with high PTSD symptomatology have an elevated risk for RA, independent of smoking, adding to emerging evidence that stress is an important determinant of physical health. PMID:26239524
Miller-Graff, Laura E; Howell, Kathryn H
Little research has examined the developmental course of posttraumatic stress symptoms (PTSS) in children. The current study aimed to identify developmental trajectories of PTSS in childhood and to examine predictors of symptom presentation in 1,178 children from the Longitudinal Studies of Child Abuse and Neglect (LONGSCAN) studies, a consortium of studies focusing on the causes and effects of child maltreatment. Most children had a history of documented reports with Child Protective Services (CPS) and all were identified as living in high-risk environments. Using group-based trajectory modeling, 3 unique developmental trajectories were identified: Resilient, Clinical-Improving (PTSS in the clinical range at baseline then declining over time), and Borderline-Stable (chronically subclinical PTSS). Children in the Clinical-Improving group were more likely than children in the Resilient group to have reports of physical abuse (RRR = 1.76), emotional abuse (RRR = 2.55), neglect (RRR = 1.57), and exposure to violence at home and in the community (RRR = 1.04). Children in the Borderline-Stable group were more likely than children in the Resilient group to have a CPS history of neglect (RRR = 2.44) and exposure to violence at home and in the community (RRR = 1.04). Many children living in high-risk environments exhibit resilience to PTSS, but exposure to witnessed violence and neglect appear to put children at chronic risk for poor adjustment. These children may require more intensive, integrated clinical services that attend to multiple adverse experiences. Copyright © 2015 International Society for Traumatic Stress Studies.
Jaquier, Véronique; Flanagan, Julianne C.; Sullivan, Tami P.
This study examines effects of psychological, physical, and sexual intimate partner violence (IPV) to alcohol and drug problems through anxiety and posttraumatic stress symptom severity among 143 community women currently experiencing IPV. Anxiety and posttraumatic stress symptom severity had unique effects on alcohol and drug problems. Higher anxiety symptom severity and higher physical IPV severity were associated with greater alcohol and drug problems. Higher posttraumatic stress symptom s...
Hypothalamic-Pituitary-Adrenal Function in Posttraumatic Stress PRINCIPAL INVESTIGATOR: Sabra Inslicht, Ph.D. RECIPIENT: Northern California Institute...Posttraumatic Stress 5b. GRANT NUMBER W81XWH-16-1-0313 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR(S) Sabra Inslicht, PhD 5d. PROJECT NUMBER 5e. TASK NUMBER...ABSTRACT Post-traumatic stress (PTS) is a common psychiatric condition that may result after combat exposure and can have a profound effect on sleep
Marinić, Igor; Supek, Fran; Kovacić, Zrnka; Rukavina, Lea; Jendricko, Tihana; Kozarić-Kovacić, Dragica
To use data mining methods in assessing diagnostic symptoms in posttraumatic stress disorder (PTSD). METHODS. The study included 102 inpatients: 51 with a diagnosis of PTSD and 51 with psychiatric diagnoses other than PTSD. Several models for predicting diagnosis were built using the random forest classifier, one of the intelligent data analysis methods. The first prediction model was based on a structured psychiatric interview, the second on psychiatric scales (Clinician-administered PTSD Scale--CAPS, Positive and Negative Syndrome Scale--PANSS, Hamilton Anxiety Scale--HAMA, and Hamilton Depression Scale--HAMD), and the third on combined data from both sources. Additional models placing more weight on one of the classes (PTSD or non-PTSD) were trained, and prototypes representing subgroups in the classes constructed. The first model was the most relevant for distinguishing PTSD diagnosis from comorbid diagnoses such as neurotic, stress-related, and somatoform disorders. The second model pointed out the scores obtained on the CAPS scale and additional PANSS scales, together with comorbid diagnoses of neurotic, stress-related, and somatoform disorders as most relevant. In the third model, psychiatric scales and the same group of comorbid diagnoses were found to be most relevant. Specialized models placing more weight on either the PTSD or non-PTSD class were able to better predict their targeted diagnoses at some expense of overall accuracy. Class subgroup prototypes mainly differed in values achieved on psychiatric scales and frequency of comorbid diagnoses. Our work demonstrated the applicability of data mining methods for the analysis of structured psychiatric data for PTSD. In all models, the group of comorbid diagnoses, including neurotic, stress-related, and somatoform disorders, surfaced as important. The important attributes of the data, based on the structured psychiatric interview, were the current symptoms and conditions such as presence and degree of
Arnold, Robert M.; Angus, Derek C.; Bryce, Cindy L.
Background Family members of patients in intensive care units (ICUs) are at risk for mental health morbidity both during and after a patient’s ICU stay. Objectives To determine prevalences of and factors associated with anxiety, depression, posttraumatic stress and complicated grief in family members of ICU patients. Design Prospective, longitudinal cohort study. Participants Fifty family members of patients in ICUs at a large university hospital participated. Measurements We used the Control Preferences Scale to determine participants’ role preferences for surrogate decision-making. We used the Hospital Anxiety and Depression Scale, Impact of Event Scale, and Inventory of Complicated Grief to measure anxiety and depression (at enrollment, 1 month, 6 months), posttraumatic stress (6 months), and complicated grief (6 months). Results We interviewed all 50 participants at enrollment, 39 (78%) at 1 month, and 34 (68%) at 6 months. At the three time points, anxiety was present in 42% (95% CI, 29–56%), 21% (95% CI, 10–35%), and 15% (95% CI, 6–29%) of participants. Depression was present in 16% (95% CI, 8–28%), 8% (95% CI, 2–19%), and 6% (95% CI, 1–18%). At 6 months, 35% (95% CI, 21–52%) of participants had posttraumatic stress. Of the 38% who were bereaved, 46% (95% CI, 22–71%) had complicated grief. Posttraumatic stress was not more common in bereaved than nonbereaved participants, and neither posttraumatic stress nor complicated grief was associated with decision-making role preference or with anxiety or depression during the patient’s ICU stay. Conclusions Symptoms of anxiety and depression diminished over time, but both bereaved and nonbereaved participants had high rates of posttraumatic stress and complicated grief. Family members should be assessed for posttraumatic stress and complicated grief. PMID:18780129
Maercker, Andreas; Hecker, Tobias; Augsburger, Mareike; Kliem, Sören
Prevalence rates are still lacking for posttraumatic stress disorder (PTSD) and complex PTSD (CPTSD) diagnoses based on the new ICD-11 criteria. In a nationwide representative German sample (N = 2524; 14-99 years), exposure to traumatic events and symptoms of PTSD or CPTSD were assessed with the International Trauma Questionnaire. A clinical variant of CPTSD with a lower threshold for core PTSD symptoms was also calculated, in addition to conditional prevalence rates dependent on trauma type and differential predictors. One-month prevalence rates were as follows: PTSD, 1.5%; CPTSD, 0.5%; and CPTSD variant, 0.7%. For PTSD, the highest conditional prevalence was associated with kidnapping or rape, and the highest CPTSD rates were associated with sexual childhood abuse or rape. PTSD and CPTSD were best differentiated by sexual violence. Combined PTSD and CPTSD (ICD-11) rates were in the range of previously reported prevalences for unified PTSD (Diagnostic and Statistical Manual of Mental Disorders, 4th Edition; ICD-10). Evidence on differential predictors of PTSD and CPTSD is still preliminary.
Walsh, Kate; Danielson, Carla Kmett; McCauley, Jenna L; Saunders, Benjamin E; Kilpatrick, Dean G; Resnick, Heidi S
Despite empirical links between sexual revictimization (ie, experiencing 2 or more sexual assaults) and posttraumatic stress disorder (PTSD), to our knowledge, no epidemiological studies document the prevalence of sexual revictimization and PTSD. Establishing estimates is essential to determine the scope, public health impact, and psychiatric sequelae of sexual revictimization. To estimate the prevalence of sexual revictimization and PTSD among 3 national female samples (adolescent, college, and adult household probability). Surveys were used to collect data from the National Women's Study-Replication (2006; college) as well as household probability samples from the National Survey of Adolescents-Replication (2005) and the National Women's Study-Replication (2006; household probability). Households and college campuses across the United States. One thousand seven hundred sixty-three adolescent girls, 2000 college women, and 3001 household-residing adult women. Behaviorally specific questions assessed unwanted sexual acts occurring over the life span owing to the use of force, threat of force, or incapacitation via drug or alcohol use. Posttraumatic stress disorder was assessed with a module validated against the criterion standard Structured Clinical Interview for DSM-IV. About 53% of victimized adolescents, 50% of victimized college women, and 58.8% of victimized household-residing women reported sexual revictimization. Current PTSD was reported by 20% of revictimized adolescents, 40% of revictimized college women, and 27.2% of revictimized household-residing women. Compared with nonvictims, odds of meeting past 6-month PTSD were 4.3 to 8.2 times higher for revictimized respondents and 2.4 to 3.5 times higher for single victims. Population prevalence estimates suggest that 769 000 adolescent girls, 625 000 college women, and 13.4 million women in US households reported sexual revictimization. Further, 154 000 sexually revictimized adolescents, 250 000 sexually
Strasshofer, David R; Peterson, Zoë D; Beagley, Marin C; Galovski, Tara E
Past research has revealed that posttraumatic stress disorder (PTSD) is characterized by disturbances in emotional reactivity, including anger reactions. In turn, posttraumatic stress symptoms (PTSS) and anger reactions have been shown to be independently associated with posttraumatic growth (PTG). As such, anger reactions may serve as a pathway of influence through which PTSS lead to PTG in trauma-exposed adults. The current study examined cross-sectional relationships among PTSS, anger reactions, and PTG in 318 participants who were exposed to the violent political protests in Ferguson, Missouri after the officer-involved shooting of Michael Brown. Specifically, anger reactions were examined as a pathway of influence through which PTSS contribute to PTG. PTSS positively predicted anger reactions and PTG. Further anger reactions were associated with PTG. Anger reactions were found to partially account for the relationship between PTSS and PTG; thus, PTSS affect PTG, in part, through anger reactions to traumatic events. These results indicate a more direct role of anger reactions in facilitating growth after the associated distress of community violence. On the basis of these findings, anger may be useful in galvanizing individuals to make positive change after traumatic events. (PsycINFO Database Record (c) 2017 APA, all rights reserved).
Troop-Gordon, Wendy; Sugimura, Niwako; Rudolph, Karen D
This research examined the development of stress responses across second to sixth grades and whether exposure to peer victimization alters stress response trajectories. Youth (338 girls; 298 boys; Mage = 7.97 years, SD = .37) reported on stress responses; teachers and youth reported on peer victimization. Latent growth curve modeling revealed an increase in effortful engagement responses and a decrease in disengagement and involuntary engagement responses during this period. Peer victimization disrupted these normative trajectories, resulting in less effortful engagement and more effortful disengagement and involuntary stress responses in early adolescence. These findings suggest that early peer victimization sensitizes youth to stress by interfering with the development of effective coping and fostering maladaptive stress responses. © 2016 The Authors. Child Development © 2016 Society for Research in Child Development, Inc.
Battle, Ceri E; James, Karen; Bromfield, Tom; Temblett, Paul
Post-traumatic stress disorder has been reported in survivors of critical illness. The aim of this study was to investigate the predictors of post-traumatic stress disorder in survivors of critical illness. Patients attending the intensive care unit (ICU) follow-up clinic completed the UK-Post-Traumatic Stress Syndrome 14-Questions Inventory and data was collected from their medical records. Predictors investigated included age, gender, Apache II score, ICU length of stay, pre-illness psychopathology; delirium and benzodiazepine administration during ICU stay and delusional memories of the ICU stay following discharge. A total of 198 patients participated, with 54 (27%) patients suffering with post-traumatic stress disorder. On multivariable logistic regression, the significant predictors of post-traumatic stress disorder were younger age, lower Apache II score, pre-illness psychopathology and delirium during the ICU stay. The predictors of post-traumatic stress disorder in this study concur with previous research however a lower Apache II score has not been previously reported.
Garthus-Niegel, Susan; von Soest, Tilmann; Vollrath, Margarete E; Eberhard-Gran, Malin
The aim of this prospective study was to examine the etiology of post-traumatic stress symptoms following childbirth within a transactional framework of stress. Participants were women (N = 1,499) from the Akershus Birth Cohort. These women were followed from pregnancy to 8 weeks postpartum. We modeled predisposing factors (e.g., fear of childbirth) and precipitating factors (subjective and objective birth experiences) as predictors of post-traumatic stress symptoms. Post-traumatic stress symptoms were measured by means of the Impact of Event Scale, objective birth experiences by means of birth journals, and subjective birth experiences by means of three questions. A structural equation model showed that subjective birth experiences had the highest association with post-traumatic stress symptoms. Moreover, they mediated the effect of predisposing factors and objective birth experiences. The results suggest that women's subjective birth experiences are the most important factor in the development of post-traumatic stress symptoms following childbirth.
Liu, An-Nuo; Wang, Lu-Lu; Li, Hui-Ping; Gong, Juan; Liu, Xiao-Hong
The literature on posttraumatic growth (PTG) is burgeoning, with the inconsistencies in the literature of the relationship between PTG and posttraumatic stress disorder (PTSD) symptoms becoming a focal point of attention. Thus, this meta-analysis aims to explore the relationship between PTG and PTSD symptoms through the Pearson correlation coefficient. A systematic search of the literature from January 1996 to November 2015 was completed. We retrieved reports on 63 studies that involved 26,951 patients. The weighted correlation coefficient revealed an effect size of 0.22 with a 95% confidence interval of 0.18 to 0.25. Meta-analysis provides evidence that PTG may be positively correlated with PTSD symptoms and that this correlation may be modified by age, trauma type, and time since trauma. Accordingly, people with high levels of PTG should not be ignored, but rather, they should continue to receive help to alleviate their PTSD symptoms.
van Zuiden, Mirjam; Frijling, Jessie L; Nawijn, Laura; Koch, Saskia B J; Goslings, J Carel; Luitse, Jan S; Biesheuvel, Tessa H; Honig, Adriaan; Veltman, Dick J; Olff, Miranda
There are currently few preventive interventions available for posttraumatic stress disorder (PTSD). Intranasal oxytocin administration early after trauma may prevent PTSD, because oxytocin administration was previously found to beneficially impact PTSD vulnerability factors, including neural fear responsiveness, peripheral stress reactivity, and socioemotional functioning. Therefore, we investigated the effects of intranasal oxytocin administration early after trauma on subsequent clinician-rated PTSD symptoms. We then assessed whether baseline characteristics moderated the intervention's effects. We performed a multicenter, randomized, double-blind, placebo-controlled clinical trial. Adult emergency department patients with moderate to severe acute distress (n = 120; 85% accident victims) were randomized to intranasal oxytocin (8 days/40 IU twice daily) or placebo (8 days/10 puffs twice daily), initiated within 12 days posttrauma. The Clinician-Administered PTSD Scale (CAPS) was administered at baseline (within 10 days posttrauma) and at 1.5, 3, and 6 months posttrauma. The intention-to-treat sample included 107 participants (oxytocin: n = 53; placebo: n = 54). We did not observe a significant group difference in CAPS total score at 1.5 months posttrauma (primary outcome) or across follow-up (secondary outcome). Secondary analyses showed that participants with high baseline CAPS scores receiving oxytocin had significantly lower CAPS scores across follow-up than participants with high baseline CAPS scores receiving placebo. Oxytocin administration early after trauma did not attenuate clinician-rated PTSD symptoms in all trauma-exposed participants with acute distress. However, participants with high acute clinician-rated PTSD symptom severity did show beneficial effects of oxytocin. Although replication is warranted, these findings suggest that oxytocin administration is a promising preventive intervention for PTSD for individuals with high acute PTSD symptoms
Spinetto, Marcela; Larregina, Luciana; Benvenuto, Cecilia
In examining predictors of Posttraumatic Stress Disorders, researchers have focused on trauma intensity, symptoms severity, personality disorders and devoted less attention to other variables. This descriptive study examine how personality disorders, intensity of trauma and demographic variables (previous trauma and vulnerability) are related to the likelihood of experiencing a trauma, and to the severity of posttraumatic symptoms in a sample of 50 patients reporting a wide range of trauma.
Full Text Available Post-traumatic stress disorder (PTSD is one of those psychiatric disorders that are still away from our attention, understanding, assessment and proper management. What could be the reason as by its name and diagnostic criteria an etiological fact is specified, namely a specific traumatic event. In our paper we aim to share and elicit some difficulties that we have met in consulting, diagnostic and management of people, who have suffered a traumatic event. On the base of a review of current psychiatric classifications and ongoing discussions we briefly summarize and discuss important key points. The definition of the event, associated with PTSD is different in DSM-III (introduced for the fist time in a classification of mental disorders, DSM-IV and ICD-10. DSM-IV is less restrictive and includes events that occur more frequently. In DSM-5, PTSD is placed in chapter “Trauma and Stressor-related disorders” and the accent is on the variable clinical characteristics of psychological distress. Emotional reactions to the traumatic event are no longer part of Criterion A. The clinical presentation varies and a number of intrusive psychological and physiological reactions of distress are described. Here comes a problem- the assessment of the trauma itself and the determination of the basic symptoms, when such an event happens. So, the skills to assess the trauma, to determine and competently attribute these symptoms to the specific event and cluster are of great importance. We conclude that a number of risk and prognostic factors should be considered in the process of assessment, diagnosis and management.
Full Text Available Objective: The objective of this study was to explore the prevalence of post-traumatic stress disorder (PTSD at veterans 8 years after war, to find out relation of PTSD with other demographic and health related variables and discover the impact of depression and trauma on PTSD on 687 veterans from six municipalities in Kosovo. Method: Participants were 687 war veterans selected from six regions of Kosovo during 2008. The Harvard Trauma Questionnaire (HTQ-40, was administered to measure PTSD and Hopkins Symptom Checklist (HSCL-25 for depression and anxiety. Pearson chi-square, analysis of variance (ANOVA, and multiple regressions were used to analyze the data. Results: Results indicated that 11.2 % of veterans even 8 years after the war ended were suffering from PTSD. Six percent of veterans with PTSD did not seek medical help. They reported to have had emotional problems and physical problems, but they did not seek medical help. The findings suggest that self-medication may be one way of veterans dealing with PTSD symptoms. Veterans with PTSD symptoms were more concerned with “family issues” than those without PTSD symptoms. Conclusions: The study found that 8 years after the war the veterans of the war in Kosovo suffer PTSD symptoms and that a good number of them do not seek help for this problem. The establishment of adequate services by the state would transform these veterans’ dealing with PTSD not into a moral challenge but into a fundamental right to equal and high-quality services.
Bub, Konstantin; Lommen, Miriam J J
Background: A growing body of evidence supports the notion that the emotional profile of Posttraumatic Stress Disorder (PTSD) may be more diverse than traditional accounts presume. PTSD's image as an anxiety-based disorder is undergoing change as the significance of other emotions in its development becomes more evident. Experimental research is needed in order to expand the understanding of underlying processes driving the development of PTSD. Objective: Experimentally test the influence of stressor-related guilt on the occurrence of PTSD symptomatology. Method: A non-clinical student sample faced an analogue trauma, a stressor in the form of a computer crash and related loss of data. We either personally blamed participants for causing the incident (blame group) or told them that it was a technical failure and therefore not their fault (no-blame group). Levels of guilt before and after the incident as well as number and associated distress of incident-related intrusions were assessed using a one-day diary and compared between groups. Results: The guilt manipulation was successful: feelings of guilt significantly increased in the blame group but not in the no-blame group. Furthermore, the blame group showed a significantly higher number of intrusions and associated distress compared to the no-blame group at one-day follow-up. Conclusions: These laboratory findings indicate that feelings of guilt may lead to increased PTSD symptomatology, supporting the view that guilt experienced in reaction to a traumatic event may be part of a causal mechanism driving the development of PTSD.
Jovanović Aleksandar A.
Full Text Available Background/Aim. Frequent expression of negative affects, hostility and violent behavior in individuals suffering from posttraumatic stress disorder (PTSD were recognized long ago, and have been retrospectively well documented in war veterans with PTSD who were shown to have an elevated risk for violent behavior when compared to both veterans without PTSD and other psychiatric patients. The aim of this study was to evaluate the accuracy of clinical prediction of violence in combat veterans suffering from PTSD. Methods. The subjects of this study, 104 male combat veterans with PTSD were assessed with the Historical, Clinical and Risk Management 20 (HCR-20, a 20-item clinicianrated instrument for assessing the risks for violence, and their acts of violence during one-year follow-up period were registered based on bimonthly check-up interviews. Results. Our findings showed that the HCR-20, as an actuarial measure, had good internal consistency reliability (α = 0.82, excellent interrater reliability (Interaclass Correlation ICC = 0.85, as well as excellent predictive validity for acts of any violence, non-physical violence or physical violence in the follow-up period (AUC = 0.82-0.86. The HCR-20 also had good interrater reliability (Cohen's kappa = 0.74, and acceptable predictive accuracy for each outcome criterion (AUC = 0.73-0.79. Conclusion. The results of this research confirm that the HCR-20 may also be applied in prediction of violent behavior in the population of patients suffering from PTSD with reliability and validity comparable with the results of previous studies where this instrument was administered to other populations of psychiatric patients.
Weber, T; Boggero, I A; Carlson, C R; Bertoli, E; Okeson, J P; de Leeuw, R
To explore the impact of interactions between smoking and symptoms of posttraumatic stress disorder (PTSD) on pain intensity, psychological distress, and pain-related functioning in patients with orofacial pain, a retrospective review was conducted of data obtained during evaluations of 610 new patients with a temporomandibular disorder who also reported a history of a traumatic event. Pain-related outcomes included measures of pain intensity, psychological distress, and pain-related functioning. Main effects of smoking status and PTSD symptom severity on pain-related outcomes were evaluated with linear regression analyses. Further analyses tested interactions between smoking status and PTSD symptom severity on pain-related outcomes. PTSD symptom severity and smoking predicted worse pain-related outcomes. Interaction analyses between PTSD symptom severity and smoking status revealed that smoking attenuated the impact of PTSD symptom severity on affective distress, although this effect was not found at high levels of PTSD symptom severity. No other significant interactions were found, but the present results identifying smoking as an ineffective coping mechanism and the likely role of inaccurate outcome expectancies support the importance of smoking cessation efforts in patients with orofacial pain. Smoking is a maladaptive mechanism for coping with pain that carries significant health- and pain-related risks while failing to fulfill smokers' expectations of affect regulation, particularly among persons with orofacial pain who also have high levels of PTSD symptom severity. Addressing smoking cessation is a critical component of comprehensive treatment. Further research is needed to develop more effective ways to help patients with pain and/or PTSD to replace smoking with more effective coping strategies. © International & American Associations for Dental Research 2016.
Hinrichs, Rebecca; Michopoulos, Vasiliki; Winters, Sterling; Rothbaum, Alex O; Rothbaum, Barbara O; Ressler, Kerry J; Jovanovic, Tanja
Increased psychophysiological reactivity is a hallmark intermediate phenotype of posttraumatic stress disorder (PTSD). Individuals with PTSD exhibit greater skin conductance (SC) responses to trauma scripts than trauma survivors without PTSD. However, trauma scripts require time for development and cannot be easily used in a single visit. Thus, there is a need for a low-cost, easy-to-use, SC recording protocol for PTSD assessment. Using a mobile device (eSense) connected to a portable tablet computer, we assessed SC reactivity to a standard trauma interview (STI) in 63 participants recruited from Grady Memorial Hospital in Atlanta, GA, approximately 1 year after trauma exposure. SC response (SCR) was calculated by subtracting the SC level (SCL) at the end of the baseline recording from the maximum SCL during the STI. SCL was significantly higher during the STI compared to baseline (P < .001), and individuals with PTSD showed significantly greater SCR than individuals without PTSD (P = .006). Logistic regression using SCR with PTSD diagnosis as the outcome showed an odds ratio of 1.76 (95% CI: 1.11-2.78). Lastly, higher SCR during the STI was also significantly associated with PTSD symptom total score controlling for demographics and trauma severity (b = 0.42, P = .001). The current study demonstrated feasibility of the use of a mobile device for assessing psychophysiological reactivity in those with PTSD. The use of this low-cost, easy-to-use mobile device to collect objective physiological data in concert with a STI can be easily disseminated in clinical and research settings. © 2017 Wiley Periodicals, Inc.
Elklit, Ask; Christiansen, Dorte Mølgaard; Palic, Sabina
Childhood sexual abuse can be extremely traumatic and lead to lifelong symptomatology. The present study examined the impact of several demographic, abuse, and psychosocial variables on posttraumatic stress disorder severity among a consecutive sample of treatment-seeking, adult child sexual abuse...... survivors (N = 480). The child sexual abuse sample was characterized by severe trauma exposure, insecure attachment, and significant traumatization, with an estimated 77% suffering from posttraumatic stress disorder, more than twice the level of the comparison group. Regression analyses revealed risk...... factors associated with the development of posttraumatic stress disorder in which the strongest predictors being additional traumas, negative affectivity, and somatization. The findings add to existing research confirming the stressful nature of child sexual abuse and the variables that contribute...
The present study examined how posttraumatic-stress-symptoms presented after prolonged traumatic exposure to rocket attacks are related to the perception of the worthiness of life among individuals in the second half of their lives. Additionally, it was questioned whether the subjective evaluation of the time one has left to live affects this relationship. Using an in-region random digit dialing methodology, phone calls made to residents in the south of Israel, we sampled 339 community-dwelling older adults (age range 50-90; M=65.44, SD=9.77) in Wave 1, 170 of whom were interviewed again in Wave 2 about a year later. Participants completed a phone-questionnaire on posttraumatic-stress-symptoms, subjective nearness-to-death, and will-to-live. The cross-sectional and longitudinal analyses results showed that higher levels of posttraumatic-stress-symptoms were positively related to higher will-to-live in both waves, among individuals who felt further away from death, while higher levels of posttraumatic-stress-symptoms were negatively related or unrelated to lower will-to-live among those who felt close to death in Waves 1and 2, respectively. The findings emphasize that perceptions regarding one's future perspective may affect the quality of the relationship between posttraumatic-stress-symptoms and will-to-live. Theoretical and practical implications are discussed. Copyright © 2017 Elsevier Ireland Ltd. All rights reserved.
Marcio Antonio de Assis
Full Text Available OBJECTIVE: In this study, we present data from a survey that aimed to assess the physical activity habits of adult Brazilian patients with Posttraumatic Stress Disorder. METHOD: Fifty male and female patients with Posttraumatic Stress Disorder participated in this study. The mean age at onset was 37±12 years, and the mean time between diagnosis and follow-up was 3.6±4.2 years. RESULTS: Substantial changes in physical activity habits were observed following the onset of PTSD. While more than half of the patients participated in physical activities prior to Posttraumatic Stress Disorder onset, there was a significant reduction in their participation afterwards. The justifications for stopping physical activities or sport participation were lack of time and lack of motivation. DISCUSSION: Several studies have shown that physical exercise decreases reverts symptoms of psychiatric disorders such as depression, anxiety and social isolation. We could therefore hypothesize that patients with Posttraumatic Stress Disorder who exercise should experience the same benefits. CONCLUSION: Our findings demonstrated that patients with Posttraumatic Stress Disorder have low levels of participation in sports or physical activities.
Ferree, Nikole K; Wheeler, Malinda; Cahill, Larry
Conservative estimates indicate that 18-25% of women in the United States will be exposed to some form of sexual assault in their lifetime. A great number of these women will develop post-traumatic stress disorder (PTSD). The current study explores the relationship between emergency contraception (EC) administration and subsequent post-traumatic stress symptoms in female sexual assault (SA) survivors. In a study population of 111 participants, post-traumatic stress symptoms were assessed approximately six months after the SA. Women who were already taking hormonal contraception (HC) at the time of the SA and those who declined EC were compared to women who took either Ogestrel or Plan B following the SA. While the administration of traditional HC and both types of EC were associated with fewer intrusive symptoms, women who took Ogestrel reported significantly lower post-traumatic stress total symptom levels than did those who took Plan B or those who declined EC. The results suggest that the manipulation of sex hormone levels with HC and EC in the immediate aftermath of trauma may influence subsequent post-traumatic stress symptoms. The current results may be useful in guiding the choice of EC. © 2012 International Association of Forensic Nurses.
Iranmanesh, Sedigheh; Shamsi, Ala; Dehghan, Mahlegha
Support of parents of children with cancer requires healthcare personnel to be knowledgeable about the prevalence of post-traumatic stress symptoms among Iranian parents of children with cancer. This study was conducted to fulfill this aim in the South-East of Iran. Using the Impact of Event Scale -Revised, for parents of children with cancer, 200 parents in two hospitals supervised by Kerman University of Medical Sciences, were assessed. The total mean score of post-traumatic stress symptoms was 41.70. Among all categories of the Impact of Event Scale -Revised, the highest mean belonged to the category of 'intrusion' 16.03 (SD = 6.24) and the lowest one belonged to the category of 'hyperarousal' 10.68 (SD = 4.58). Based on the results, mothers had higher post-traumatic stress symptoms compared with fathers (p post-traumatic stress symptoms among mothers was 2.49 times more than that among fathers (p = 0.01). There was no association between sociodemographic data and post-traumatic stress symptoms. More research is needed to elucidate the Iranian parents' experience of having children with cancer.
Balasinorwala, Vanshree Patil; Shah, Nilesh
The 26/11 terror attacks on Mumbai have been internationally denounced. Acute stress disorder is common in victims of terror. To find out the prevalence and to correlate acute stress disorder, 70 hospitalised victims of terror were assessed for presence of the same using DSM-IV TR criteria. Demographic data and clinical variables were also collected. Acute stress disorder was found in 30% patients. On demographic profile and severity of injury, there were some interesting observations and differences between the victims who developed acute stress disorder and those who did not; though none of the differences reached the level of statistical significance. This study documents the occurrence of acute stress disorder in the victims of 26/11 terror attack.
Flores, Elena; Tschann, Jeanne M.; Dimas, Juanita M.; Pasch, Lauri A.; de Groat, Cynthia L.
Utilizing the concept of race-based traumatic stress, this study tested whether posttraumatic stress symptoms explain the process by which perceived discrimination is related to health risk behaviors among Mexican American adolescents. One hundred ten participants were recruited from a large health maintenance organization in Northern California.…
Van Rooij, S. J H; Kennis, M.; Sjouwerman, R.; Van Den Heuvel, M. P.; Kahn, R. S.; Geuze, E.
Background Smaller hippocampal volume has often been observed in patients with post-traumatic stress disorder (PTSD). However, there is no consensus whether this is a result of stress/trauma exposure, or constitutes a vulnerability factor for the development of PTSD. Second, it is unclear whether
Borovac Štefanović, Leda; Kalinić, Dubravka; Mimica, Ninoslav; Beer Ljubić, Blanka; Aladrović, Jasna; Mandelsamen Perica, Marina; Curić, Maja; Grošić, Petra Folnegović; Delaš, Ivančica
The aim of this study was to measure the parameters of oxidative stress in the blood of patients with post-traumatic stress disorder. The study included 80 male war veterans who participated actively in the Homeland war in Croatia. Volunteers were divided into two groups: 50 veterans diagnosed with post-traumatic stress disorder and 30 without diagnosis. The self-assessment Hospital Anxiety and Depression Scale and the Beck Depression Inventory were used to detect the severity of depression and anxiety in the post-traumatic stress disorder patients. Catalytic concentrations of superoxide dismutase and glutathione peroxidase in erythrocytes and the concentration of malondialdehyde in serum were measured spectrophotometrically. Although the catalytic concentrations of erythrocyte superoxide dismutase and erythrocyte glutathione peroxidase were within the reference range for both groups, the values obtained for the post-traumatic stress disorder group were significantly lower (Ppost-traumatic stress disorder may indicate a weaker response to oxidative stress due to impaired enzyme activity and/or decreased synthesis. Conversely, no significant changes in serum malondialdehyde concentrations suggest a compensated balance and adaptive response to (oxidative) stress. © The Author(s) 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.
Jongedijk, R. A.; Carlier, I. V.; Schreuder, B. J.; Gersons, B. P.
The recently developed concept Disorder of Extreme Stress Not Otherwise Specified (DES NOS) or complex posttraumatic stress disorder (complex PTSD) is designed to encompass long-standing symptoms not present in PTSD. An exploratory investigation of PTSD and DES NOS was performed with the Structured
Morina, N.; Stangier, U.; Risch, A.K.
The present study investigated the role of experiential avoidance in posttraumatic stress disorder (PTSD) following war-related stress. Eighty-four civilian war survivors were assigned to one of three PTSD groups — current PTSD, recovered PTSD and non-PTSD. Groups were subsequently compared in
Hauer, Beatrijs J. A.; Wessel, Ineke; Engelhard, Iris M.; Peeters, Louis L.; Dalgleish, Tim
Prior research has shown that reduced autobiographical memory specificity predicts an increase in post-traumatic stress severity in traumatised individuals. Studies have also demonstrated that reduced memory specificity predicts later symptoms of depression after pregnancy-related life stress. So
Burke, Henry R.; Mayer, Stuart
Minnesota Multiphasic Personality Inventory profiles of Post-traumatic Stress Syndrome outpatients (N=30) and newly admitted random psychiatric inpatient veterans (N=30) were found to be practically identical and were consistent with diagnosis of schizophrenia, indicating the severity of delayed response to stress in Vietnam veterans. (NRB)
Visser, E.; Gosens, T.; den Oudsten, B.L.; de Vries, J.
Background: Trauma patients suffer from acute stress disorder (ASD) and posttraumatic stress disorder (PTSD), but it is unknown how these disorders develop over time and when treatment is effective. Our aim was to systematically review (1) the course and predictors of ASD and PTSD after trauma and
van Rooij, S J H; Kennis, M; Sjouwerman, R; van den Heuvel, M P|info:eu-repo/dai/nl/313905738; Kahn, R S; Geuze, E
BACKGROUND: Smaller hippocampal volume has often been observed in patients with post-traumatic stress disorder (PTSD). However, there is no consensus whether this is a result of stress/trauma exposure, or constitutes a vulnerability factor for the development of PTSD. Second, it is unclear whether
Armistead-Jehle, Patrick; Johnston, Scott L.; Wade, Nathaniel G.; Ecklund, Christofer J.
Combat exposure is a consistent predictor of posttraumatic stress (PTS). Understanding factors that might buffer the effects of combat exposure is crucial for helping service members weather the stress of war. In a study of U.S. Marines returning from Iraq, hierarchical multiple regression analyses revealed that unit cohesion and combat exposure…
Weisenberg, Matisyohu; And Others
Assessed the interrelation between two instruments for soldiers who suffered from combat stress reactions. Subjects suffering from posttraumatic stress disorder according to the Diagnostic and Statistical Manual of Mental Disorders (DSM-III) yielded higher scores on the Intrusion and Avoidance factors of the Impact of Event Scale. The Intrusion…
Tay, Alvin Kuowei; Rees, Susan; Chen, Jack; Kareth, Moses; Silove, Derrick
The validity of applying the construct of post-traumatic stress disorder (PTSD) across cultures has been the subject of contention. Although PTSD symptoms have been identified across multiple cultures, questions remain whether the constellation represents a coherent construct with an interpretable factor structure across diverse populations, especially those naïve to western notions of mental disorder. An important additional question is whether a constellation of Complex-PTSD (C-PTSD) can be identified and if so, whether there are distinctions between that disorder and core PTSD in patterns of antecedent traumatic events. Our study amongst West Papuan refugees in Papua New Guinea (PNG) aimed to examine the factorial structure of PTSD based on the DSM-IV, DSM-5, ICD-10 and ICD-11 definitions, and C-PTSD according to proposed ICD-11 criteria. We also investigated domains of traumatic events (TEs) and broader psychosocial effects of conflict (sense of safety and injustice) associated with the factorial structures identified. Culturally adapted measures were applied to assess exposure to conflict-related traumatic events (TEs), refugees' sense of safety and justice, and symptoms of PTSD and C-PTSD amongst 230 West Papuan refugees residing in Port Morseby, PNG. Confirmatory factor analysis (CFA) supported a unitary construct of both ICD-10 and ICD-11 PTSD, comprising the conventional symptom subdomains of intrusion, avoidance, and hyperarousal. In contrast, CFA did not identify a unitary construct underlying C-PTSD. The interaction of witnessing murders and sense of injustice was associated with both the intrusion and avoidance domains of PTSD, but not with the unique symptom clusters characterizing C-PTSD. Our findings support the ICD PTSD construct and its three-factor structure in this transcultural refugee population. Traumatic experiences of witnessing murder associated with a sense of injustice were specifically related to the intrusion and avoidance domains of
Hall, Darlene Kordich
Compares three groups of young sexually abused children on seven "Complex" Posttraumatic Stress Disorder/Disorders of Extreme Stress (CP/DES) indices. As cumulative number of types of trauma increased, the number of CP/DES symptoms rose. Results suggest that CP/DES also characterizes sexually abused children, especially those who have…
Kuwert, Philipp; Spitzer, Carsten; Rosenthal, Jenny; Freyberger, Harald J
The aim of the study was to determine the amount of trauma impact and significant post-traumatic stress symptoms, which can indicate a possible post-traumatic stress disorder (PTSD), in a sample of former German child soldiers of World War II. 103 participants were recruited through the press, then administered a modified Post-traumatic Diagnostic Scale (PDS). Subjects reported a high degree of trauma exposure, with 4.9% reporting significant post-traumatic stress symptoms after WW II, and 1.9% reporting that these symptoms persist to the present. In line with other studies on child soldiers in actual conflict settings, our data document a high degree of trauma exposure during war. Surprisingly, the prevalence of significant post-traumatic stress symptoms indicating a possible PTSD was low compared to other groups of aging, long-term survivors of war trauma. Despite some limitations our data highlight the need for further studies to identify resilience and coping factors in traumatized child soldiers.
Full Text Available This study aims to review empirical studies that were used to evaluate the effectiveness of cognitive-behavioral group therapy programs for the treatment for posttraumatic stress disorder. Articles in English and Turkish that were published between the years of 2000 and 2015 (February have been searched in national and international databases. The articles that were gathered by the search have been read and the ones that were not therapy effectiveness studies, cognitive behavioral group therapies and that included posttraumatic stress disorder comorbid with alcohol/substance abuse, personality disorders and psychotic disorders were eliminated. The remaining 13 studies that fulfiilrf research criteria were introduced in the context of method and therapy characteristics. It can be seen that the cognitive behavioral group therapies are effective in decreasing the symptoms of posttraumatic stress disorder and/or comorbid disorders. [Psikiyatride Guncel Yaklasimlar - Current Approaches in Psychiatry 2016; 8(Supplement 1: 95-107
Ravn, Sophie Lykkegaard; Karstoft, Karen-Inge; Sterling, Michele
-injured is needed. The current study aimed to identify trajectories of posttraumatic stress symptoms following whiplash-injury and test predictors and functional outcomes of such trajectories. Methods:In a prospective cohort design assessing pain, pain-related disability, fear-avoidance-beliefs, pain...... not recover over time after a whiplash-trauma. This group showed enhanced levels of psycho-social and physical pain-related disability at 6 months, and initial levels of pain and depression predicted membership, which can be target of intervention.......Background: Posttraumatic stress is highly prevalent among whiplash-injured and related to pain-related symptomatology. While mutual maintenance between pain and posttraumatic stress has been suggested, knowledge on individual differences in the course of these symptoms among whiplash...
Granja, Cristina; Gomes, Ernestina; Amaro, Augusta; Ribeiro, Orquídea; Jones, Christina; Carneiro, António; Costa-Pereira, Altamiro
To assess the factual and delusional memories reported by intensive care unit survivors and its relationship with the development of Posttraumatic Stress Syndrome (PTSS). Multicenter observational cohort study. Nine Portuguese intensive care units, as part of a multicenter study. Between January and June 2005, 1,174 patients were admitted across the nine intensive care units. Two hundred thirty-nine patients were excluded, 14 with 49, indicating a higher risk of developing posttraumatic stress disorder. A PTSS-14 score > 49 was significantly associated with not remembering the hospital stay before intensive care unit admission. Amnesia for the early period of critical illness (early amnesia) was positively associated with the level of posttraumatic stress disorder-related symptoms, which may be a proxy for severity of disease at the time of intensive care unit admission.
Alix, Stéphanie; Cossette, Louise; Hébert, Martine; Cyr, Mireille; Frappier, Jean-Yves
Sexual abuse is associated with a host of negative repercussions in adolescence. Yet the possible mechanisms linking sexual abuse and negative outcomes are understudied. The purpose of this study was to investigate the relationships among self-blame, shame, coping strategies, posttraumatic stress disorder, depressive symptoms, and suicidal ideation. The sample included 147 sexually abused adolescent girls between 14 and 18 years of age. A total of 66% of girls reached clinical score for posttraumatic stress disorder, and 53% reached clinical score for depressive symptoms. Close to half (46%) reported suicidal thoughts in the past 3 months. Shame was found to partially mediate the relationship between self-blame and posttraumatic stress disorder. Shame and depressive symptoms were also found to partially mediate the relationship between self-blame and suicidal ideation. Results suggest that shame is a crucial target in interventions designed for sexually abused adolescent girls.
Als, Lorraine C; Picouto, Maria D; O'Donnell, Kieran J; Nadel, Simon; Cooper, Mehrengise; Pierce, Christine M; Kramer, Tami; Glover, Vivette A S; Garralda, M Elena
In this exploratory case-control study, we investigated basal cortisol regulation in 5-16-year-old children, 3-6 months following PICU (paediatric intensive care) admission. This was nested within a study of child psychological and cognitive function; 47 children were assessed alongside 56 healthy controls. Saliva samples were collected three times per day (immediately after waking, waking +30 min, and waking +12 h) over two consecutive weekdays. In addition, data on posttraumatic stress symptoms were ascertained from 33 PICU admitted children using the Impact of Events Scale-8 (IES-8). Primary analysis revealed no significant differences in basal cortisol concentrations between PICU discharged children and healthy controls (p > 0.05). Secondary analysis in the PICU group identified a significant positive association between posttraumatic stress symptoms and evening (waking +12 h) cortisol concentrations (p = 0.004). However, when subject to multivariate analysis, evening cortisol was a modest independent predictor of IES-8 scores, relative to the presence of septic illness and poor pre-morbid health. We conclude that paediatric critical illness does not appear to result in marked perturbations to basal cortisol at 3-6 month following discharge. There was evidence of a link between evening cortisol and symptoms of PTSD, but this was not a robust effect and requires further elucidation.
Huang, Junhua; Liu, Qunying; Li, Jinliang; Li, Xuejiang; You, Jin; Zhang, Liang; Tian, Changfu; Luan, Rongsheng
Previous studies have suggested that the incidence of post-traumatic stress disorder in earthquake rescue workers is relatively high. Risk factors for this disorder include demographic characteristics, earthquake-related high-risk factors, risk factors in the rescue process, personality, social support and coping style. This study examined the current status of a unit of 1 040 rescue workers who participated in earthquake relief for the Wenchuan earthquake that occurred on May 12(th), 2008. Post-traumatic stress disorder was diagnosed primarily using the Clinician-Administered Post-traumatic Stress Disorder Scale during structured interviews. Univariate and multivariate statistical analyses were used to examine major risk factors that contributed to the incidence of post-traumatic stress disorder. Results revealed that the incidence of this disorder in the rescue group was 5.96%. The impact factors in univariate analysis included death of family members, contact with corpses or witnessing of the deceased or seriously injured, near-death experience, severe injury or mental trauma in the rescue process and working at the epicenter of the earthquake. Correlation analysis suggested that post-traumatic stress disorder was positively correlated with psychotic and neurotic personalities, negative coping and low social support. Impact factors in multivariate logistic regression analysis included near-death experience, severe injury or mental trauma, working in the epicenter of the rescue, neurotic personality, negative coping and low social support, among which low social support had the largest odds ratio of 20.42. Findings showed that the occurrence of post-traumatic stress disorder was the result of the interaction of multiple factors.
Weiss, Nicole H.; Duke, Aaron A.; Sullivan, Tami P.
Posttraumatic stress disorder (PTSD) is highly prevalent among individuals who experience intimate partner violence (IPV) and associated with aggression in intimate relationships. The present study examined whether alcohol dependence (AD) attenuates the relation between PTSD and IPV-victimized women’s use of physical, psychological, and sexual aggression. Participants were recruited from the community and included 147 women who engage in substance use and experience IPV [80.3% Black; M age = 38.2 years (SD = 10.6); M income = $14,323 (SD = $12,832)]. Women with (vs. without) AD reported using significantly more physical and psychological aggression (ηp2 = .12 and .03, respectively). The probable PTSD × AD interaction emerged as a significant correlate of physical and sexual aggression (ηp2s = .03). Post-hoc analyses revealed higher levels of physical aggression among women with probable PTSD and AD and no-PTSD and AD compared to women with probable PTSD and no-AD (Cohen’s ds = 1.09 and 0.63, respectively) and women with no-PTSD and no-AD (Cohen’s ds = 0.92 and 0.60, respectively). Further, women with PTSD and AD reported higher levels of sexual aggression than women with no-PTSD and AD (Cohen’s d = 0.80). Findings suggest the utility of identifying and treating PTSD-AD among IPV-victimized women. PMID:25322884
McLaughlin, Katie A; Koenen, Karestan C; Hill, Eric D; Petukhova, Maria; Sampson, Nancy A; Zaslavsky, Alan M; Kessler, Ronald C
Although exposure to potentially traumatic experiences (PTEs) is common among youths in the United States, information on posttraumatic stress disorder (PTSD) risk associated with PTEs is limited. We estimate lifetime prevalence of exposure to PTEs and PTSD, PTE-specific risk of PTSD, and associations of sociodemographics and temporally prior DSM-IV disorders with PTE exposure, PTSD given exposure, and PTSD recovery among U.S. adolescents. Data were drawn from 6,483 adolescent-parent pairs in the National Comorbidity Survey Replication Adolescent Supplement (NCS-A), a national survey of adolescents aged 13 through 17 years. Lifetime exposure to interpersonal violence, accidents/injuries, network/witnessing, and other PTEs was assessed along with DSM-IV PTSD and other distress, fear, behavior, and substance disorders. A majority (61.8%) of adolescents experienced a lifetime PTE. Lifetime prevalence of DSM-IV PTSD was 4.7% and was significantly higher among females (7.3%) than among males (2.2%). Exposure to PTEs, particularly interpersonal violence, was highest among adolescents not living with both biological parents and with pre-existing behavior disorders. Conditional probability of PTSD was highest for PTEs involving interpersonal violence. Predictors of PTSD among PTE-exposed adolescents included female gender, prior PTE exposure, and pre-existing fear and distress disorders. One-third (33.0%) of adolescents with lifetime PTSD continued to meet criteria within 30 days of interview. Poverty, U.S. nativity, bipolar disorder, and PTE exposure occurring after the focal trauma predicted nonrecovery. Interventions designed to prevent PTSD in PTE-exposed youths should be targeted at victims of interpersonal violence with pre-existing fear and distress disorders, whereas interventions designed to reduce PTSD chronicity should attempt to prevent secondary PTE exposure. Copyright © 2013 American Academy of Child and Adolescent Psychiatry. Published by Elsevier Inc. All
Carlos Otero, Juan; Njenga, Frank G
Identification and treatment of posttraumatic stress disorder (PTSD) are important following a disaster. Insights into how these aims can be achieved may be obtained from previous disasters. This article describes mental health initiatives following the 1999 flooding in Vargas State, Venezuela, and the 1998 U.S. Embassy bombing in Nairobi, Kenya. Following the Vargas State floods, a specialist mental health center devoted to the diagnosis, treatment, and follow-up of PTSD was established. Awareness and acceptance of the clinic was promoted by media campaigns and community-based activities. After 18 months, approximately 5000 people had been screened, of whom 62% were diagnosed with PTSD and treated. Moreover, the clinic's activities had expanded to include treatment of other medical conditions and assistance with nonmedical needs. Following the Nairobi bombing, a mass media campaign was initiated to create awareness of PTSD symptoms and help victims come to terms with their experience. This campaign was found to be well received and helpful. In addition, counselors were trained to support people living or working close to the blast. These examples show that mental health initiatives are feasible after a disaster and highlight a number of issues: (1) The intervention should be tailored to the needs of the target population; (2) Communication should be simple and appropriate; (3) Community-based activities are valuable in promoting awareness and acceptance of mental health initiatives; (4) Reducing the stigma often associated with mental health problems is important; and (5) The mass media can be helpful in promoting awareness of mental health issues following major trauma.
Robinson, Sarah R.; Jobson, Laura A.
Objective: The aim of this study was to investigate the relationship between post-traumatic stress disorder (PTSD) symptoms and autobiographical memory specificity in older adults. Method: Older adult trauma survivors (N = 23) completed the Autobiographical Memory Test, Posttraumatic Stress Diagnostic Scale, and Addenbrooke's Cognitive…
Curran, B; Collier, E
WHAT IS KNOWN ON THE SUBJECT?: The needs of older people with long-term mental illness are not very well addressed in policy and research. Older people are not a homogenous group and people ageing with long-term mental illness have potentially unique or specific needs. WHAT THIS PAPER ADDS TO EXISTING KNOWLEDGE?: A unique example of the idiosyncratic and contextual nature of individual strengths and the abilities in managing personal recovery when experiencing long-term mental illness. Emotional exhaustion experienced after long-term mental health compromises the ability to manage feelings, potentially a special feature of life time mental ill health. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Recognition that the hard work involved in successfully managing long-term personal recovery may be important in preventing suicide in later life. The need to understand a person's life story to make sense of their experience of mental illness and to recognize long-term mental illness to later life as part of a persons' established identity. The importance of appreciating the place of early memories for understanding older person's mental health in their present. Introduction Ageing with mental illness is a neglected area of research and policy. People who grow older to later life with ongoing mental health problems may not have their needs well understood. This understanding is important if mental health services are to ensure direct or indirect age discrimination is avoided. Aim This paper aims to explore issues relating to later life and ageing with mental illness focused on the story of Bernard (who was 84 years of age at the time of writing) who lived with a diagnosis of post-traumatic stress disorder (PTSD). Method The paper is co-authored by Bernard and the researcher he originally told his story to as a participant in a biographical research study exploring mental ill health through the life course. In the original research study, Bernard completed a curriculum vitae
Abrams, Thad E; Blevins, Amy; Weg, Mark W Vander
Several studies have reported on the co-occurrence of chronic obstructive pulmonary disease (COPD) and psychiatric conditions, with the most robust evidence base demonstrating an impact of comorbid anxiety and depression on COPD-related outcomes. In recent years, research has sought to determine if there is a co-occurrence between COPD and posttraumatic stress disorder (PTSD) as well as for associations between PTSD and COPD-related outcomes. To date, there have been no published reviews summarizing this emerging literature. The primary objective of this review was to determine if there is adequate evidence to support a co-occurrence between PTSD and COPD. Secondary objectives were to: 1) determine if there are important clinical considerations regarding the impact of PTSD on COPD management, and 2) identify targeted areas for further research. A structured review was performed using a systematic search strategy limited to studies in English, addressing adults, and to articles that examined: 1) the co-occurrence of COPD and PTSD and 2) the impact of PTSD on COPD-related outcomes. To be included, articles must have addressed some type of nonreversible obstructive lung pathology. A total of 598 articles were identified for initial review. Upon applying the inclusion and exclusion criteria, n=19 articles or abstracts addressed our stated objectives. Overall, there is inconclusive evidence to support the co-occurrence between PTSD and COPD. Studies finding a significant co-occurrence generally had inferior methods of identifying COPD; in contrast, studies that utilized more robust COPD measures (such as a physician exam) generally failed to find a relationship. Among studies that examined the impact of PTSD on COPD-related outcomes, there was more consistent evidence that PTSD affects the perception of respiratory symptom burden and management. In addition, methods for measuring an important confounder (smoking) were generally lacking. There is inconclusive evidence to
Miller, M W; Sadeh, N
Post-traumatic stress disorder (PTSD) is associated with elevated risk for a variety of age-related diseases and neurodegeneration. In this paper, we review evidence relevant to the hypothesis that chronic PTSD constitutes a form of persistent life stress that potentiates oxidative stress (OXS) and accelerates cellular aging. We provide an overview of empirical studies that have examined the effects of psychological stress on OXS, discuss the stress-perpetuating characteristics of PTSD, and then identify mechanisms by which PTSD might promote OXS and accelerated aging. We review studies on OXS-related genes and the role that they may have in moderating the effects of PTSD on neural integrity and conclude with a discussion of directions for future research on antioxidant treatments and biomarkers of accelerated aging in PTSD.
Taycan, Okan; Yildirim, Ahmet
Exposure to multiple traumatic events, particularly in childhood, has been shown to result in more complex symptoms than those seen after exposure to a single traumatic event. In case of overlooking the link between trauma and psychopathology, patients with multiple traumatic experiences receive a variety of different diagnoses that are unable to completely cover the clinical picture. Misdiagnoses of genuine cases inevitably lead to mistreatment. A diagnosis of complex post-traumatic stress disorder has been proposed to cover the emerging psychopathology in survivors of multiple traumas. This present report aimed to discuss the construct and to increase the awareness of complex post-traumatic stress disorder diagnosis among mental health professionals.
Elklit, Ask; Rønholt, Stine; Karsberg, Sidsel
Abstract Background In 2004, a firework factory in a residential area of a large Danish city exploded. The children at the local school were screened for symptoms of posttraumatic stress disorder (PTSD) 16 months and 3 years after the incident. A large proportion of the children still suffered from...... with posttraumatic stress would be associated with reductions in symptoms. The second aim was to evaluate the usefulness of the Darryl, a cartoon-based PTSD screening instrument. Methods One hundred and eight children participated in the treatment program, all of whom fulfilled at least two out of the three DSM...
O Connor, Maja; Zachariae, Robert
This chapter focuses on posttraumatic stress reactions after being diagnosed with and treated for breast cancer. Posttraumatic stress symptoms (PTSS) are evident in a significant proportion of women after having experienced diagnosis and treatment of breast cancer. Several risk factors...... for developing long-term PTSS after breast cancer have been identified. Younger age, low education and income, pre-cancer previous psychiatric history, cancer disease severity, poor physical functioning, and acute symptoms of PTSS are predictors of long-term post-cancer PTSS, with poor physical functioning...
Lin, Yu-Hua; Kao, Chia-Chan; Wu, Shu-Fen; Hung, Shu-Ling; Yang, Hsing-Yu; Tung, Hong-Yi
To determine the level of post-traumatic stress symptoms and to identify demographics, disease history and clinical symptoms that were associated with post-traumatic stress symptoms among patients with gynaecological, breast or colorectal cancer in Taiwan. Literature indicated that 7·3-35·2% of patients with cancer had experienced level of post-traumatic stress symptoms. However, the post-traumatic stress symptoms among patients with cancer in Taiwan was not documented. A cross-sectional study. A total of 347 participants recruited from two general hospitals in southern Taiwan. They completed the Chinese version of Davidson Trauma Scale and a profile describing their demographics and clinical symptoms. Disease history was collected from medical records. Approximately 21·6% of participants reported higher score on Chinese version of Davidson Trauma Scale (Mean ± SD = 22·85 ± 24·12). The top four scores on Chinese version of Davidson Trauma Scale were painful memories, insomnia, shortened lifespan and flashbacks. The risk factors of post-traumatic stress symptoms were suicidal intention (OR = 2·29, 95% CI = 1·86-2·82), chemotherapy (OR = 2·13, 1·18-3·84), metastasis (OR = 2·07, 1·29-3·34), cancer-specific symptoms (OR = 1·21, 1·15-1·27) and high education (OR = 1·75, 1·10-2·78). To prevent post-traumatic stress symptoms, patients with cancer should be routinely screened by psychiatrists for post-traumatic stress symptoms, for ongoing symptom control and suicidal intention. Patients with cancer who are at risk of suicidal behaviour should be enrolled in suicide prevention programmes. Nurses need to assess post-traumatic stress symptoms of patients with cancer, particularly those who with high education, suffered from complications of chemotherapy, metastasis and cancer-specific symptoms and suicidal intention. © 2016 John Wiley & Sons Ltd.
Hellerup, Janne; Andersen, Søren Bo; Høgh (Hogh), Annie
Understanding the development of posttraumatic stress disorder (PTSD) implicates research regarding factors besides the preceding traumatic event. This study investigated the influence of predisposing personality traits on development of PTSD in a group of Danish Soldiers deployed to Afghanistan (N...... = 445). Using a prospective design data was collected using questionnaires including the NEO Five Factor Inventory and the Posttraumatic Stress Disorder Checklist. The results showed a PTSD-prevalence of 9.2% in the total sample 2.5 years after homecoming. Using Kruskal-Wallis, Mann-Whitney U...
Ewing-Cobbs, Linda; Prasad, Mary R; Cox, Charles S; Granger, Douglas A; Duque, Gerardo; Swank, Paul R
Injury is the leading cause of death and disability in childhood. Injured children are at high risk for developing alterations in stress response systems and post-traumatic stress symptoms (PTSS) that may compromise long-term physical and psychological health. In a prospective, observational cohort study, we examined individual differences in, and correlates of, stress-reactivity of the hypothalamic-pituitary-adrenal axis (HPA; salivary cortisol) and autonomic nervous system (ANS; salivary alpha amylase, sAA) following pediatric injury. Participants were 8-15 years of age and hospitalized for traumatic brain injury (TBI; n=55; M age=13.9 yrs; 40 males) or extracranial injury (EI; n=29; M age 12.3 yrs, 20 males) following vehicular accidents. Six months post-injury, saliva was collected before and after the Trier Social Stress Test and later assayed for cortisol and sAA. Relative to a healthy non-injured comparison group (n=33; M age=12.5 yrs, 16 males), injured children (ages 8-12 years), but not adolescents (ages 13-15 yrs), had higher cortisol levels; regardless of age, injured participants showed dampened cortisol reactivity to social evaluative threat. Compared to participants with EI, children with TBI had elevated cortisol and adolescents had elevated sAA. With respect to PTSS, individual differences in sAA were negatively correlated with avoidance in the TBI group and positively correlated with emotional numbing within the EI group. Importantly, psychological and neurobiological sequelae were weakly related to injury severity. Given the high prevalence of pediatric injury, these sequelae affect many children and represent a significant public health concern. Consequently, surveillance of post-traumatic sequelae should include the full spectrum of injury severity. Monitoring the activity, reactivity, and regulation of biological systems sensitive to environmental insults may advance our understanding of individual differences in sequelae and adaptation
Pinto, Ricardo J; Correia-Santos, Patrícia; Levendosky, Alytia; Jongenelen, Inês
Studies of the effects of intimate partner violence (IPV) on parenting have usually not examined the role of the maternal perceptions, either its stress or maternal satisfaction, on the mothers' and children's mental health functioning. The present study aimed to assess whether maternal satisfaction, parenting stress, and social support are significantly associated with women's psychological functioning. The study also assessed whether maternal perceptions of the role of parenting were significantly associated with children's emotional well-being and social behavior. The sample included 160 mothers, 79 (49.4%) who were living with the aggressors and 81 (50.6%) in shelters, and their children ( n = 61). The findings suggested that high levels of maternal satisfaction and perception of social support were significantly negatively associated with women's posttraumatic stress disorder (PTSD) symptoms and psychological distress, whereas parenting stress was significantly positively associated with these outcomes. Maternal satisfaction was the only parenting variable that predicted both maternal mental health and children's emotional and behavioral problems, suggesting that it is a protective factor for both mothers and children. This study suggests that increasing maternal satisfaction with parenting and reducing parenting stress might promote better adjustment for both women and children victims of IPV.
Scigała, Dawid Konrad; Ziołek, Jakub; Kwiatkowski, Krzysztof
Poland is a country in which every year there is a lot of motor vehicle accidents, number of victims is one of the highest in European union. Helping patients after motor vehicle accidents should base on cooperation of doctors and psychologists because holistic approach to patient enables rapid and effective rehabilitation. To show connection between physical damage cause in motor vehicle accident with mental trauma, which increase on process of full recovery. There were 31 victims who were involved in motor vehicle accidents not more than one month ago. In the second group there were people who was never involved in motor vehicle accident. The procedure consisted on filling demographic questionnaire, state traite anxety inventory and aqute stress disorder questionnare. In the second part of the research was to accomplish the emotional Stroop task, which based on selecting the name of the color of a word, which was on the screen. There were two types of the words: negative related to motor vehicle accident and neutral. Participants from the research group had higher level of anxiety than participants from control group and they had significantly longer reaction time in particular on words associated to accident, which could be the signal of problems with cognitive processes because of the anxiety. Furthermore participants with head injuries and upper limbs (whitout dominant limb) have had longer reaction times in Stroop test than participants with leg injuries, it indicating on higher level of anxiety and feeling of insecurity. It should be noted that looking on a character an range of a injuries, role that participant attend in accident (victims have more emotional disturbance), because it could determinate rate of recovery and the way communication with the patient.
Harb, Birgit Maria; Wonisch, Manfred; Fruhwald, Friedrich; Fazekas, Christian
Symptoms of a post-traumatic stress disorder can follow Tako-tsubo cardiomyopathy. This vignette describes such a linkage and exemplifies the risk that these symptoms may remain undetected. After a skiing accident that had evoked existential fear of suffocation, a post-menopausal woman was diagnosed with Tako-tsubo syndrome and myocardial contusion. Symptoms of post-traumatic stress disorder appeared 2 weeks after remission of the cardiomyopathy. Two months later, a psychological assessment was conducted during cardiac rehabilitation. A post-traumatic stress disorder was diagnosed and successfully treated by narrative exposure. This case report suggests that these patients should be informed during the initial hospital stay that post-traumatic stress symptoms could appear. It also suggests including a screening for post-traumatic stress disorder in the follow-up of these patients.
Xu, Jiuping; Wu, Wei
This study investigated the role of perceived stress as a possible moderating factor between posttraumatic growth (PTG) and work satisfaction. A stratified random sampling strategy was used to survey 2080 adult survivors of the 2008 Sichuan earthquake. The Posttraumatic Growth Inventory, the Job Satisfaction Index Scale and the Perceived Stress Scale were used in the assessment of the posttraumatic growth, work satisfaction and perceived stress respectively, and hierarchical multiple regression analyses were used for the analysis. The findings highlight work satisfaction as an important factor in both the prediction of posttraumatic growth and for its moderating effect on perceived stress. Some demographic characteristics, such as gender, education level, and housing condition were found to also affect the survivors' posttraumatic growth. This conclusion indicates that managers should pay closer attention to their employees' psychological state after a disaster and medical practitioners should consider survivors' work status and perceived stress when dispensing mental health care. Copyright © 2014 Elsevier Inc. All rights reserved.
Cantón-Cortés, David; Cantón, José
The purpose of this study was to examine the effects of child sexual abuse (CSA) on the use of coping strategies and post-traumatic stress disorder (PTSD) scores in young adults, as well as the role of avoidance and approach coping strategies in those PTSD scores in CSA victims. The role of coping strategies was studied by considering their possible interactive effect with the continuity of abuse and the relationship with the perpetrator; the effect of coping strategies on PTSD was also compared between CSA victim and non-CSA victim participants. The sample was comprised of 138 victims of CSA and another 138 participants selected as a comparison group. Data about child sexual abuse were obtained from a questionnaire developed for this purpose. Coping strategies were assessed with the How I Deal with Things Scale (Burt & Katz, 1987), while PTSD scores were assessed with the "Escala de Gravedad de Síntomas del Trastorno de Estrés Postraumático" (Severity of Symptoms of PTSD Scale; Echeburúa et al., 1997). Participants who had been victims of CSA showed significantly higher PTSD scores and lower approach coping strategies scores. However, differences in avoidance coping strategies between groups were not consistent and did not always follow the expected direction. Only the use of avoidance coping strategies was related to PTSD, participants who used these showing higher scores. The effects of avoidance strategies were stronger in continued than in isolated abuse, in intrafamilial than in extrafamilial abuse and in CSA victims than in non-victims. These results confirm the idea of CSA as a high-risk experience that can affect the victim's coping strategies and lead to PTSD to a lesser or greater extent depending on the coping strategy used. Moreover, the role of these strategies varies depending on whether or not the participant is a victim of CSA and on the characteristics of abuse (continuity and relationship with the perpetrator). In terms of intervention, a
Zerach, Gadi; Magal, Ortal
This longitudinal study examined posttraumatic stress disorder (PTSD) and anxiety symptoms among men attending the birth of their first offspring. Furthermore, we examined the moderating role of anxiety sensitivity (AS) and intolerance of uncertainty in the association between exposure to stress during birth and PTSD and anxiety symptoms. Participants were Israeli men (n = 171) who were assessed with self-report questionnaires during the third trimester of pregnancy (T1) and approximately a month following birth (T2). Results show that the rates of postnatal PTSD and anxiety symptoms were relatively low. Subjective exposure to stress during birth and AS predicted PTSD in T2, above and beyond other negative life events and PTSD in T1. In addition, AS moderated the relations between subjective exposure to stress during birth and PTSD symptoms. Pregnancy and childbirth professionals may benefit from the insight that men with high levels of AS might experience childbirth as a highly stressful situation with possible posttraumatic stress symptoms.
Dale-Hewitt, Vanessa; Slade, Pauline; Wright, Ingram; Cree, Michelle; Tully, Chris
Childbirth for some women can be experienced as a traumatic event whereby it is appraised as threatening to life and associated with feelings of fear, helplessness or horror. These women may develop symptoms consistent with post-traumatic stress disorder or its sub-clinical symptoms (post-traumatic stress, PTS). Cognitive processes such as attentional biases have been identified in individuals with PTS exposed to other traumatic events. This study used an experimental design (the modified Stroop task) to investigate the relationship between attentional biases and PTS symptoms in 50 women who experienced their labour and delivery as stressful and responded with fear, helplessness and horror. Attentional biases away from childbirth words were significantly associated with both symptoms of post-traumatic stress and more negative experiences of childbirth. A negative experience was also associated with more severe symptoms of PTS. Positive experiences were unassociated with attentional biases or symptoms. Post-traumatic stress responses, in this population, may be associated with avoidance, and through influencing cognitive processing, acting as a maintaining factor of distress.
Slavin-Spenny, Olga M; Cohen, Jay L; Oberleitner, Lindsay M; Lumley, Mark A
Research on emotional disclosure should test the effects of different disclosure methods and whether symptoms are affected differently than post-traumatic growth. We randomized 214 participants with unresolved stressful experiences to four disclosure conditions (written, private spoken, talking to a passive listener, talking to an active facilitator) or two control conditions. All groups had one 30-minute session. After 6 weeks, disclosure groups reported more post-traumatic growth than controls, and disclosure conditions were similar in this effect. All groups decreased in stress symptoms (intrusions, avoidance, psychological and physical symptoms), but disclosure did not differ from control. We conclude that 30 minutes of disclosure leads to post-traumatic growth but not necessarily symptom reduction, and various disclosure methods have similar effects. Research on the effects of disclosure should focus on the benefits of growth as well as symptom reduction. © 2010 Wiley Periodicals, Inc.
Priebe, Kathlen; Steil, Regina; Kleindienst, Nikolaus; Dyer, Anne S; Krüger, Antje; Bohus, Martin
There is an ongoing debate how to treat posttraumatic stress disorder related to childhood sexual abuse. In Germany patients mostly receive a psychodynamically oriented treatment with a long-lasting stabilization before the use of exposure-based interventions. The number of randomized controlled trials on posttraumatic stress disorder related to childhood sexual abuse is quite limited. The results of these studies show that cognitive-behavioral trauma-focussing interventions are very efficacious with large effect sizes. 2 controlled studies on psychodynamically oriented treatment found only small improvements in posttraumatic symptoms. The high dropout rates in prolonged exposure especially in patients with co-occurring personality disorders point towards the need of a emotion regulation training before the exposure phase. Future studies should include subgroup-analyses and the assessment of adverse effects during therapy. © Georg Thieme Verlag KG Stuttgart · New York.
Wei, Chuguang; Han, Jin; Zhang, Yuqing; Hannak, Walter; Liu, Zhengkui
Purpose Post-traumatic stress disorder (PTSD) and post-traumatic growth (PTG) are two different outcomes that may occur after experiencing traumatic events. Meanwhile, the traumatic exposure level and emotion response played an important role in the process. The present study first evaluated the relationship between PTSD, PTG, and traumatic exposure level and then compared the characteristics of emotional response through response time of the affective priming paradigm. Methods For...
Japuntich, Sandra J; Gregor, Kristin; Pineles, Suzanne L; Gradus, Jaimie L; Street, Amy E; Prabhala, Rao; Rasmusson, Ann M
Epidemiological research has demonstrated that tobacco use and posttraumatic stress disorder (PTSD) frequently co-occur and are highly prevalent among Veterans; research with female Veterans is limited. Given the increasing numbers of women deployed to combat zones in recent conflicts, the objective of the current study was to examine gender-specific associations between deployment stress, tobacco use and postdeployment PTSD symptoms. Two thousand thirteen Veterans deployed to Afghanistan and Iraq (50.9% female; mean age = 35.53) completed a postdeployment, mailed survey that assessed tobacco use before, during, and after deployment, deployment stressors, and postdeployment PTSD symptoms. Warfare stress was associated with initiation and increases in tobacco use during deployment in both men and women, whereas harassment stress was associated with initiation and increases in tobacco use in women only. Only among women was continued postdeployment tobacco use associated with postdeployment PTSD symptoms. We found a dose-dependent relationship between deployment stress and adoption and escalation of tobacco use; the stressors that provoked initiation and escalation of tobacco use differed by gender. Continued tobacco use after deployment was associated with PTSD in women suggesting that women used tobacco more selectively than men to regulate negative affect. Implications of this work are that training before combat and during combat on healthy means of coping with deployment stress is needed to prevent tobacco use. For women, reducing harassment stress during deployment and early treatment of acute stress and PTSD during and soon after deployment may prevent intractable tobacco use. (c) 2016 APA, all rights reserved).
Haye, Paul A. La; Batzdorf, Ulrich
Posttraumatic syringomyelia is becoming increasingly recognized as a sequel to major and minor spinal cord injury, paralleling the development and widespread availability of magnetic resonance imaging as a diagnostic modality for evaluating possible spinal pathologic lesions. Delayed, subacute, or progressive neurologic deterioration in victims of traumatic spinal injury with “fixed deficits” should raise the suspicion of posttraumatic syringomyelia. Alternatively, it may present as sensory o...
van Delft, Ivanka; Finkenauer, Catrin; Tybur, Joshua M; Lamers-Winkelman, Francien
Nonoffending mothers of sexually abused children often exhibit high levels of posttraumatic stress (PTS) symptoms. Emerging evidence suggests that trait-like individual differences in sensitivity to disgust play a role in the development of PTS symptoms. One such individual difference, disgust sensitivity, has not been examined as far as we are aware among victims of secondary traumatic stress. The current study examined associations between disgust sensitivity and PTS symptoms among mothers of sexually abused children (N = 72). Mothers completed the Impact of Event Scale-Revised and the Three Domain Disgust Scale (Tybur, Lieberman, & Griskevicius, 2009). More than one third of mothers scored above a suggested cutoff (mean score = 1.5) for high levels of PTS symptoms. Hierarchical linear regression analysis results indicated that sexual disgust sensitivity (β = .39, p = .002) was associated with PTS symptoms (R(2) = .18). An interaction analysis showed that sexual disgust sensitivity was associated with maternal PTS symptoms only when the perpetrator was not biologically related to the child (β = -.32, p = .047; R(2) = .28). Our findings suggested that sexual disgust sensitivity may be a risk factor for developing PTS symptoms among mothers of sexually abused children. Copyright © 2016 International Society for Traumatic Stress Studies.
Jung, Young-Eun; Song, Jeong-Min; Chong, Jihye; Seo, Ho-Jun; Chae, Jeong-Ho
This study compared the mental symptoms, especially symptoms of posttraumatic stress disorder (PTSD), of women who escaped prostitution, helping activists at shelters, and matched control subjects. We assessed 113 female ex-prostitutes who had been living at a shelter, 81 helping activists, and 65 control subjects using self-reporting questionnaires on demographic data, symptoms related to trauma and PTSD, stress-related reactions, and other mental health factors. Female ex-prostitutes had significantly higher stress response, somatization, depression, fatigue, frustration, sleep, smoking and alcohol problems, and more frequent and serious PTSD symptoms than the other 2 groups. Helping activists also had significantly higher tension, sleep and smoking problems, and more frequent and serious PTSD symptoms than control subjects. These findings show that engagement in prostitution may increase the risks of exposure to violence, which may psychologically traumatize not only the prostitutes themselves but also the people who help them, and that the effects of the trauma last for a long time. Future research is needed to develop a method to assess specific factors that may contribute to vicarious trauma of prostitution, and protect field workers of prostitute victims from vicarious trauma.
Ironson, G; Wynings, C; Schneiderman, N; Baum, A; Rodriguez, M; Greenwood, D; Benight, C; Antoni, M; LaPerriere, A; Huang, H S; Klimas, N; Fletcher, M A
To examine the impact of and relationship between exposure to Hurricane Andrew, a severe stressor, posttraumatic stress symptoms and immune measures. Blood draws and questionnaires were taken from community volunteer subjects living in the damaged neighborhoods between 1 and 4 months after the Hurricane. The sample exhibited high levels of posttraumatic stress symptoms by questionnaire (33% overall; 76% with at least one symptom cluster), and 44% scored in the high impact range on the Impact of Events (IES) scale. A substantial proportion of variance in posttraumatic stress symptoms could be accounted for by four hurricane experience variables (damage, loss, life threat, and injury), with perceived loss being the highest correlate. Of the five immune measures studied Natural Killer Cell Cytotoxicity (NKCC) was the only measure that was meaningfully related (negatively) to both damage and psychological variables (loss, intrusive thoughts, and posttraumatic stress disorder (PTSD). White blood cell counts (WBCs) were significantly positively related with the degree of loss and PTSD experienced. Both NKCC (lower) and WBC were significantly related to retrospective self-reported increase of somatic symptoms after the hurricane. Overall, the community sample was significantly lower in NKCC, CD4 and CD8 number, and higher in NK cell number compared to laboratory controls. Finally, evidence was found for new onset of sleep problems as a mediator of the posttraumatic symptom-NKCC relationship. Several immune measures differed from controls after Hurricane Andrew. Negative (intrusive) thoughts and PTSD were related to lower NKCC. Loss was a key correlate of both posttraumatic symptoms and immune (NKCC, WBC) measures.
Rubin, David C; Dennis, Michelle F; Beckham, Jean C
To provide the three-way comparisons needed to test existing theories, we compared (1) most-stressful memories to other memories and (2) involuntary to voluntary memories (3) in 75 community dwelling adults with and 42 without a current diagnosis of posttraumatic stress disorder (PTSD). Each rated their three most-stressful, three most-positive, seven most-important and 15 word-cued autobiographical memories, and completed tests of personality and mood. Involuntary memories were then recorded and rated as they occurred for 2 weeks. Standard mechanisms of cognition and affect applied to extreme events accounted for the properties of stressful memories. Involuntary memories had greater emotional intensity than voluntary memories, but were not more frequently related to traumatic events. The emotional intensity, rehearsal, and centrality to the life story of both voluntary and involuntary memories, rather than incoherence of voluntary traumatic memories and enhanced availability of involuntary traumatic memories, were the properties of autobiographical memories associated with PTSD. Copyright © 2011 Elsevier Inc. All rights reserved.
Apr 4, 2000 ... Ireland) in 1987 in which eleven people were killed and 60 injured, all victims had high scores on the GHQ indicating poor mental health when examined at six months and at one year, and 50% of the survivors examined had developed. PTSD at six months(3). The significance of this finding to the August ...
Richards, Anne; Metzler, Thomas J; Ruoff, Leslie M; Inslicht, Sabra S; Rao, Madhu; Talbot, Lisa S; Neylan, Thomas C
A growing literature shows prominent sex effects for risk for post-traumatic stress disorder and associated medical comorbid burden. Previous research indicates that post-traumatic stress disorder is associated with reduced slow wave sleep, which may have implications for overall health, and abnormalities in rapid eye movement sleep, which have been implicated in specific post-traumatic stress disorder symptoms, but most research has been conducted in male subjects. We therefore sought to compare objective measures of sleep in male and female post-traumatic stress disorder subjects with age- and sex-matched control subjects. We used a cross-sectional, 2 × 2 design (post-traumatic stress disorder/control × female/male) involving83 medically healthy, non-medicated adults aged 19-39 years in the inpatient sleep laboratory. Visual electroencephalographic analysis demonstrated that post-traumatic stress disorder was associated with lower slow wave sleep duration (F(3,82) = 7.63, P = 0.007) and slow wave sleep percentage (F(3,82) = 6.11, P = 0.016). There was also a group × sex interaction effect for rapid eye movement sleep duration (F(3,82) = 4.08, P = 0.047) and rapid eye movement sleep percentage (F(3,82) = 4.30, P = 0.041), explained by greater rapid eye movement sleep in post-traumatic stress disorder females compared to control females, a difference not seen in male subjects. Quantitative electroencephalography analysis demonstrated that post-traumatic stress disorder was associated with lower energy in the delta spectrum (F(3,82) = 6.79, P = 0.011) in non-rapid eye movement sleep. Slow wave sleep and delta findings were more pronounced in males. Removal of post-traumatic stress disorder subjects with comorbid major depressive disorder, who had greater post-traumatic stress disorder severity, strengthened delta effects but reduced rapid eye movement effects to non-significance. These findings support previous evidence that post-traumatic
Montefiore, D; Mallet, L; Lévy, R; Allilaire, J-F; Pélissolo, A
Post-traumatic stress disorder (PTSD) is often associated with other psychiatric syndromes. However, studies exploring conversion and PTSD comorbidity are scarce. This paper reports the case of a 45 year-old patient without medical or psychiatric history. In 2003, he suddenly started suffering from amnesia and symptoms of delirium: he was at his office with a cup of coffee but he did not remember why. Aphasia, trembling, behavioural disorders appeared over the next hours and days. Numerous neurological examinations and laboratory tests (including cerebral imagery) were performed without evidence of any physical disease. Three psychiatric examinations were also negative, even if a possible psychogenic origin was hypothesized. Neurological or psychiatric diagnoses were discussed but without definitive conclusion. One year later, the symptoms were unchanged until the patient watched a movie ("Mystic River") that described the story of a man with sexual abuse in childhood. He suddenly remembered that he lived the same experience when he was 8 years old. At the end of the movie, his wife surprisingly noticed that he was walking and speaking normally. All the neurological symptoms disappeared. Unfortunately, symptoms of a severe PTSD appeared, as well as a major depressive disorder. The patient and his parents remembered that he had been more irritable, depressed and anxious at school and during the night, between 8 and 13 years of age, with a possible PTSD during this period. He always refused to talk with his parents about the traumatic event. When he was 13, the family moved house, the patient seemed to forget everything and the symptoms disappeared. About thirty years later, the symptoms were similar with the reexperien of the traumatic event through unwanted recollections, distressing images, nightmares, or flashbacks. He had also symptoms of hyperarousal with physiological manifestations, such as irritability, insomnia, impaired concentration, hypervigilance, and
Olff, Miranda; Langeland, Willie; Witteveen, Anke; Denys, Damiaan
Although cognitive-behavioral therapy (CBT) is an effective treatment for posttraumatic stress disorder (PTSD), many patients fail to attain remission with CBT. The authors propose augmentation of CBT with oxytocin in the treatment of PTSD. Oxytocin has a combination of pharmacologic effects that
Terranova, Andrew M.; Boxer, Paul; Morris, Amanda Sheffield
This investigation examined psychosocial and behavioral factors involved in the course of post-traumatic stress disorder (PTSD) symptoms in youth affected by Hurricane Katrina. Participants (N = 152; 54% female; 61% Caucasian; mean age = 11.5 years) self-reported on hurricane exposure, PTSD symptoms, fear reactivity, regulatory abilities, social…
Cloitre, Marylene; Chase Stovall McClough,K.; Miranda, Regina; Chemtob, Claude M.
This study examined the related contributions of the therapeutic alliance and negative mood regulation to the outcome of a 2-phase treatment for childhood abuse-related posttraumatic stress disorder (PTSD). Phase 1 focused on stabilization and preparatory skills building, whereas Phase 2 was comprised primarily of imaginal exposure to traumatic…
Beals, Kelsey R.; Scott, David A.
This article focuses on Posttraumatic Stress Disorder that is largely overlooked in the counseling field and literature, specifically in children and adolescents. Etiology, treatment options, and the course in which the disorder manifests itself holds great importance in understanding the grave effects these traumatic events have on youth. This…
He, Qiwei; Glas, Cornelis A.W.; Veldkamp, Bernard P.
This article explores the generalizability of the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) diagnostic criteria for post-traumatic stress disorder (PTSD) to various subpopulations. Besides identifying the differential symptom functioning (also referred to as
Knaevelsrud, Christine; Maercker, Andreas
Advances in communication technology offer additional strategies for providing psychological treatment. Previous trials of Internet-based treatment approaches reported significant reductions in posttraumatic stress and related symptoms in response to Internet-based treatments relative to control groups. However, empirical data on the long-term effects of those approaches are sparse. In order to evaluate the long-term effect of an Internet-based intervention, the authors conducted an 18-month follow-up of an Internet-based cognitive behavioural therapy for posttraumatic stress. Severity of posttraumatic stress symptoms was the primary outcome. Additional measures were depression, anxiety, mental and physical health, and health care utilization during the follow-up period. Treatment group participants (n = 34) were assessed 1.5 years after completing treatment. Results indicated that reductions in symptoms of posttraumatic stress symptoms, depression, and anxiety found at posttreatment were sustained during the 18-month follow-up period. Preliminary evidence on long-term effects of Internet-based health care as shown in this study is promising. However, research with larger and clinically more diverse samples is needed to fully assess the clinical impact and potential of Internet-based health care provision.
Nixon, Reginald D. V.; Ellis, Alicia A.; Nehmy, Thomas J.; Ball, Shelley-Anne
Three screening methods to predict posttraumatic stress disorder (PTSD) and depression symptoms in children following single-incident trauma were tested. Children and adolescents (N = 90; aged 7-17 years) were assessed within 4 weeks of an injury that led to hospital treatment and followed up 3 and 6 months later. Screening methods were adapted…
Arzy, Ronit; Amir, Marianne; Kotler, Moshe
The increasing prevalence of domestic violence in Israel has engendered a critical need to identify and treat battered women. This paper looks at Posttraumatic Stress disorder (PTSD) and considers its predictors among battered women. The research sample was comprised of a sample of 91 battered women between the ages of 20 and 60 who applied to the…
Liverant, Gabrielle I.; Suvak, Michael K.; Pineles, Suzanne L.; Resick, Patricia A.
Objective: Trauma-focused psychotherapies reduce both posttraumatic stress disorder (PTSD) and co-occurring depression. However, little is known about the relationship between changes in PTSD and depression during treatment. This study examined the association between changes in PTSD and depression during the course of cognitive processing therapy…
Williams, Linda S.
Purpose: The purpose of this study was to identify and describe to what degree foster care students perceive that the elements of posttraumatic stress disorder (PTSD) affect their academic performance in postsecondary education. In addition, it was the purpose of this study to identify the perceived impacts of internal and external influences on…
Jackson, Lovie J.; O'Brien, Kirk; Pecora, Peter J.
Little is known about the prevalence of posttraumatic stress disorder (PTSD) in adult alumni of foster care and its demographic and contextual correlates. This is one of the first studies to report on racial/ethnic and gender differences and the influence of foster care experiences (i.e., revictimization during foster care, placement change rate,…
Dubow, Eric F.; Huesmann, L. Rowell; Boxer, Paul; Landau, Simha; Dvir, Shira; Shikaki, Khalil; Ginges, Jeremy
We examine the role of family- and individual-level protective factors in the relation between exposure to ethnic-political conflict and violence and posttraumatic stress among Israeli and Palestinian youth. Specifically, we examine whether parental mental health (lack of depression), positive parenting, children's self-esteem, and academic…
Olff, Miranda; Polak, A Rosaura; Witteveen, Anke B; Denys, D.
BACKGROUND: Posttraumatic stress disorder (PTSD) has been associated with neurocognitive deficits, such as impaired verbal memory and executive functioning. Less is known about executive function and the role of comorbid depression in PTSD. Recently, studies have shown that verbal memory impairments
Dixon, Angela; Howie, Pauline; Starling, Jean
Objective: To document the rate of posttraumatic stress disorder (PTSD) in female juvenile offenders and its relationship to trauma history, comorbid diagnoses, attributional style, and family functioning. Method: The psychological profiles and trauma histories of 100 incarcerated female juvenile offenders (ages 13.5-19 years) were assessed using…
Mehtar, Mohamad; Mukaddes, Nahit Motavalli
Although children and adolescents with developmental disabilities are said to have higher risks of abuse than those without, trauma and Posttraumatic Stress Disorder (PTSD) are little examined in those diagnosed with Autistic Spectrum Disorders (ASDs). Our study aims to assess trauma types, prevalence, risk factors and symptoms; and PTSD in…
Op den Velde, W; Aarts, PGH; Falger, PRJ; Hovens, JE; van Duijn, H; de Groen, JHM; van Duijn, MAJ
Aims: The relationship between alcohol consumption, cigarette smoking and post-traumatic stress disorder (PTSD) was studied in 147 male former members of the civilian resistance against the Nazi occupation of Holland during World War II. Methods: The subjects were interviewed at home. Measures
Fogler, Jason M.; Shipherd, Jillian C.; Clarke, Stephanie; Jensen, Jennifer; Rowe, Erin
The literature on clergy-perpetrated sexual abuse suggests that there are two modal populations of survivors: boys and adult women. We review what is known about trauma and post-traumatic stress disorder following sexual abuse and explore the different treatment needs for these two survivor groups. For children, clergy-perpetrated sexual abuse can…
Mulick, Patrick S.; Naugle, Amy E.
This study investigated the efficacy of 10-weeks of Behavioral Activation (BA) in the treatment of comorbid Post-traumatic Stress Disorder (PTSD) and Major Depressive Disorder (MDD) in four adults using a nonconcurrent multiple baseline across participants design. All participants met full "DSM-IV" criteria for both MDD and PTSD at the…
Lyons, Judith A.; Scotti, Joseph R.
The utility of using the Keane Minnesota Multiphasic Personality Inventory (MMPI) Posttraumatic Stress Disorder scale as an instrument separate from the full MMPI was evaluated. Results with 175 African American and white male veterans support use of the scale as an alternative to the full test. (SLD)
Sijbrandij, Marit; Olff, Miranda; Reitsma, Johannes B.; Carlier, Ingrid V. E.; de Vries, Mirjam H.; Gersons, Berthold P. R.
OBJECTIVE: The purpose of this study was to evaluate the efficacy of brief cognitive behavioral therapy for patients with acute posttraumatic stress disorder (PTSD) resulting from various types of psychological trauma. METHOD: The authors randomly assigned 143 patients with acute PTSD (irrespective
Hansen, J. S.; Simonsen, E.
The current study screened for post-traumatic stress disorder (PTSD) and self-harming behaviours, often related to borderline personality disorder (BPD), among individuals in a job centre considered unemployable primarily for psychological reasons. Participants (N = 112) filled in questionnaires...
Nichols, Beverly L.; And Others
Delayed and chronic symptoms of Posttraumatic Stress Disorder (PTSD) have been documented in Vietnam veterans for up to 10-15 years following the stressor and in veterans of World War II and Korea for as long as 40 years. Group therapy for Vietnam veterans with PTSD has been found to be an effective treatment, but prior research has not tested…
The study used publicly available data on post-traumatic stress disorder in a sample of the Australian population with a history of sexual abuse to demonstrate how this evidence can inform economic analyses. The 2007 Australian Mental Health Survey revealed that 8.3% of 993 adolescents experienced childhood sexual abuse, of which 40.2% were…
Full Text Available Introduction: Acute myocardial infarction (AMI is one of the most frequent causes of death worldwide, which may result in post-traumatic stress (acute or chronic, as well as in psychological distress, both of which change to a decisive extent the life and daily routine of the patient. Purpose: To investigate the experience of post-traumatic stress disorder in patients who suffered an AMI and its effect on their quality of life. Methodology: This qualitative research was conducted using the hermeneutic/phenomenological approach. Using with the method of semi-structured interviews, 20 (15 men, 5 women patients described their experiences. The data were analyzed using the empirically grounded theory. Results: Patients who suffered an AMI exhibited a series of acute post-traumatic stress symptoms during the first hours after the onset of the disease, which sometimes may be evident for up to two years. The daily presence of psychological distress and the evident manifestation of the concept of spiritual maturation significantly altered their daily habits. Conclusions: Patients with AMI experience post-traumatic stress which starts in the first hours after the event and may last for up to two years, which significantly affect their quality of life.
Sinski, Jennifer Blevins
Postsecondary institutions currently face the largest influx of veteran students since World War II. As the number of veteran students who may experience learning problems caused by Post-Traumatic Stress Disorder and/or Traumatic Brain Injury continues to rise, the need for instructional strategies that address their needs increases. Educators may…
Moore, Nykeisha; Wadsworth, John; Cory, James
Post-traumatic stress disorder (PTSD) is an anxiety syndrome that can develop after exposure to a traumatic event in which harm occurred or was threatened. PTSD is often treated with group therapy. Rehabilitation counselors need to be aware of the group treatments for PTSD because counselors may be leaders of group therapy, may work with consumers…
Dos Santos Dias, A.M.; Sales, L.; Mooren, G.T.M.; Mota Cardoso, R.; Kleber, R.J.
Background/Objective: Childhood maltreatment (CM) has been associated with revictimization and post-traumatic stress disorder (PTSD). However, this relation is hardly examined in South European countries, and in community samples. We tested these associations in a convenience sample of 1,200
Ruwaard, J.; Lange, A.; Lindefors, N.; Andersson, G.
Post-traumatic stress disorder (PTSD) and complicated grief are related disorders for which well-described and effective cognitive-behavioural therapeutic procedures exist that are firmly rooted in theoretical work. As a result, several research groups have been able to successfully translate these
Tolin, David F.; Foa, Edna B.
Meta-analyses of studies yielding sex-specific risk of potentially traumatic events (PTEs) and posttraumatic stress disorder (PTSD) indicated that female participants were more likely than male participants to meet criteria for PTSD, although they were less likely to experience PTEs. Female participants were more likely than male participants to…
Opsteegh, Lonneke; Reinders-Messelink, Heleen A.; Groothoff, Johan W.; Postema, Klass; Dijkstra, Pieter U.; van der Sluis, Corry K.
Purpose Symptoms of posttraumatic stress disorder (PTSD) in patients with hand injuries may delay return to work, even when criteria of the Diagnostic and Statistical Manual of Mental Disorders-IV are not met. This study investigated which biomedical and psychosocial factors relate to symptoms of
Olff, Miranda; Polak, A. Rosaura; Witteveen, Anke B.; Denys, Damiaan
Posttraumatic stress disorder (PTSD) has been associated with neurocognitive deficits, such as impaired verbal memory and executive functioning. Less is known about executive function and the role of comorbid depression in PTSD. Recently, studies have shown that verbal memory impairments may be
Haagen, Joris F G; Ter Heide, F Jackie June; Mooren, Trudy M; Knipscheer, Jeroen W; Kleber, Rolf J
OBJECTIVES: Given the recent peak in refugee numbers and refugees' high odds of developing post-traumatic stress disorder (PTSD), finding ways to alleviate PTSD in refugees is of vital importance. However, there are major differences in PTSD treatment response between refugees, the determinants of
This paper describes the psychodynamic psychotherapy of a 20-year-old African woman with post-traumatic stress disorder (PTSD). 'Mphumi' entered therapy a year after her father's friend had repeatedly raped her. The paper documents the process of therapy and uses the case material to examine theoretical issues ...
Sijbrandij, Marit; Olff, Miranda; Opmeer, Brent C.; Carlier, Ingrid V. E.; Gersons, Berthold P. R.
Background: This study examined the accuracy of the 17-item. Dutch version of the Davidson Trauma Scale (DTS) and the four-item SPAN (Startle, Physiological Arousal, Anger and Numbness) to detect survivors at risk for posttraumatic stress disorder (PTSD) within the first 2 weeks after the trauma.
Lommen, M.J.J.; Engelhard, I.M.; Sijbrandij, M.; van Hout, M.A.; Hermans, D.
In the aftermath of a traumatic event, many people suffer from psychological distress, but only a minority develops posttraumatic stress disorder (PTSD). Pre-trauma individual differences in fear conditioning, most notably reduced extinction learning, have been proposed as playing an important role
Weierich, Mariann R.; Nock, Matthew K.
Prior research consistently has shown a strong relation between childhood abuse and nonsuicidal self-injury (NSSI), yet it is unclear why this relation exists. The authors examined 2 specific posttraumatic stress disorder (PTSD) symptom clusters as potential mechanisms through which childhood abuse may be related to NSSI. Participants were 86…
Carlier, I. V.; Voerman, A. E.; Gersons, B. P.
Certain individuals, such as police officers, are exposed to traumatic events as part of their occupational roles. In an effort to prevent psychological illnesses, notably the post-traumatic stress disorder, from arising out of work-related traumatic incidents, psychological interventions have been
Kleim, Birgit; Ehlers, Anke
In this prospective longitudinal study, the authors examined the relationship between reduced specificity in autobiographical memory retrieval and the development of depression, posttraumatic stress disorder (PTSD), and specific phobia after injury in an assault. Assault survivors (N = 203) completed the Autobiographical Memory Test (J. M. G.…
Jaffee, Laura Jordan
A slew of recent news coverage has reported favorably on the use of virtual reality video games as a treatment for post-traumatic stress disorder (PTSD) in U.S. soldiers returning from Iraq and Afghanistan. Drawing on critical disability studies work, this paper argues that such depictions (re)produce a depoliticized framework for understanding…
van Dam, D.; Vedel, E.; Ehring, T.; Emmelkamp, P.M.G.
This article gives an overview of research into psychological treatments for concurrent posttraumatic stress disorder (PTSD) and substance used disorder (SUD), with a special focus on the effectiveness of treatments addressing both disorders compared to treatments addressing one of the disorders
Ehring, T.; Ehlers, A.
There is preliminary evidence that enhanced priming for trauma-related cues plays a role in posttraumatic stress disorder (PTSD). A prospective study of 119 motor vehicle accident survivors investigated whether priming for trauma-related stimuli predicts PTSD. Participants completed a modified
Research with child soldiers is crucial to improving mental health services after war. This research also can illuminate innovative approaches to treating post-traumatic stress disorder (PTSD) among adult soldiers, veterans and other trauma survivors in high-income countries. A key contribution is the role of social ecology for trauma-healing interventions.
Stein, Dan J.; McLaughlin, Katie A.; Koenen, Karestan C.; Atwoli, Lukoye; Friedman, Matthew J.; Hill, Eric D.; Maercker, Andreas; Petukhova, Maria; Shahly, Victoria; van Ommeren, Mark; Alonso, Jordi; Borges, Guilherme; de Girolamo, Giovanni; de Jonge, Peter; Demyttenaere, Koen; Florescu, Silvia; Karam, Elie G.; Kawakami, Norito; Matschinger, Herbert; Okoliyski, Michail; Posada-Villa, Jose; Scott, Kate M.; Viana, Maria Carmen; Kessler, Ronald C.
Background: The development of the Diagnostic and Statistical Manual of Mental Disorders 5th edition (DSM-5) and ICD-11 has led to reconsideration of diagnostic criteria for posttraumatic stress disorder (PTSD). The World Mental Health (WMH) Surveys allow investigation of the implications of the
Cordova, Matthew J.; And Others
Assessed Quality Of Life (QOL) and symptoms similar to posttraumatic stress disorder (PTSD) in women posttreatment for breast cancer. Negatively related PTSD symptomatology to QOL, income, and age. Time since treatment, type of cytotoxic treatment, and stage of disease were unrelated to PTSD symptoms. Suggests that in breast cancer survivors,…
Dückers, M.L.A.; Alisic, E.; Brewin, C.R.
Background: Determinants of cross-national differences in the prevalence of mental illness are poorly understood. Aims: To test whether national post-traumatic stress disorder (PTSD) rates can be explained by (a) rates of exposure to trauma and (b) countries’ overall cultural and socioeconomic
Boelen, Paul A.; van de Schoot, Rens; van den Hout, Marcel A.; de Keijser, Jos; van den Bout, Jan
Background: This study examined the distinctiveness of symptoms of Prolonged Grief Disorder (PGD), depression, and posttraumatic stress disorder (PTSD). We compared the fit of a one-factor model with the fit of four hierarchical models in which symptoms formed three distinct correlated higher-order
Boelen, P.A.|info:eu-repo/dai/nl/174011954; Van de Schoot, R.|info:eu-repo/dai/nl/304833207; Van den Hout, M.A.|info:eu-repo/dai/nl/070445354; de Keijser, J.; Van den Bout, J.|info:eu-repo/dai/nl/071594094
Background This study examined the distinctiveness of symptoms of Prolonged Grief Disorder (PGD), depression, and posttraumatic stress disorder (PTSD). We compared the fit of a one-factor model with the fit of four hierarchical models in which symptoms formed three distinct correlated higher-order
Leiner, Amy S.; Kearns, Megan C.; Jackson, Joan L.; Astin, Millie C.; Rothbaum, Barbara O.
Objective: This study investigated the impact of avoidant coping on treatment outcome in rape-related posttraumatic stress disorder (PTSD). Method: Adult women with rape-related PTSD (N = 62) received 9 sessions of prolonged exposure (PE) or eye movement desensitization and reprocessing (EMDR). The mean age for the sample was 34.7 years, and race…
Lyttle, Nigel; Dorahy, Martin J.; Hanna, Donncha; Huntjens, Rafaele J. C.
Cognitive models of posttraumatic stress disorder (PTSD) assert that memory processes play a significant role in PTSD (see e.g., Ehlers & Clark, 2000). Intrusive reexperiencing in PTSD has been linked to perceptual processing of trauma-related material with a corresponding hypothesized lack of
de Vries, Giel-Jan; Mocking, Roel; Lok, Anja; Assies, Johanna; Schene, Aart; Olff, Miranda
Although fatty acid (FA)-supplementation studies are currently being implemented, in fact little is known about FA-profiles in posttraumatic stress disorder (PTSD). Therefore, the present study aimed at comparing FA-concentrations between PTSD-patients and healthy controls. A cross-sectional study
de Vries, G.J.; Mocking, R.; Lok, A.; Assies, J.; Schene, A.H.; Olff, M.
BACKGROUND: Although fatty acid (FA)-supplementation studies are currently being implemented, in fact little is known about FA-profiles in posttraumatic stress disorder (PTSD). Therefore, the present study aimed at comparing FA-concentrations between PTSD-patients and healthy controls. METHODS: A
Furuta, Marie; Sandall, Jane; Cooper, Derek; Bick, Debra
This study aimed to identify factors associated with birth-related post-traumatic stress symptoms during the early postnatal period. Secondary analysis was conducted using data from a prospective cohort study of 1824 women who gave birth in one large hospital in England. Post-traumatic stress symptoms were measured by the Impact of Event Scale at 6 to 8 weeks postpartum. Zero-inflated negative binomial regression models were developed for analyses. Results showed that post-traumatic stress symptoms were more frequently observed in black women and in women who had a higher pre-pregnancy BMI compared to those with a lower BMI. Women who have a history of mental illness as well as those who gave birth before arriving at the hospital, underwent an emergency caesarean section or experienced severe maternal morbidity or neonatal complications also showed symptoms. Women's perceived control during labour and birth significantly reduced the effects of some risk factors. A higher level of perceived social support during the postnatal period also reduced the risk of post-traumatic stress symptoms. From the perspective of clinical practice, improving women's sense of control during labour and birth appears to be important, as does providing social support following the birth.
Engelhard, Iris M.; Huijding, Jorg; van den Hout, Marcel A.; de Jong, Peter J.
The purpose of this prospective study was to examine whether explicit and implicit vulnerability associations before and after trauma exposure predict the onset and persistence of post-traumatic stress disorder (PTSD) symptoms. The implicit association test (IAT) was modified to assess associations
Morina, N.; Böhme, H.F.; Morina, L.; Asmundson, G.J.G.
Research on the dimensionality of post-traumatic stress disorder (PTSD) has generally failed to provide support for the three clusters of PTSD suggested in the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV). However, much research has been restricted to samples in North America and
Deblinger, Esther; And Others
This investigation compared rates of post-traumatic stress disorder symptoms across sexually abused (N=29), physically abused (N=20), and nonabused (N=29) psychiatrically hospitalized children. Overall rates were not significantly different across groups, but significant differences were found with respect to specific symptoms, especially in…
Briggs, Lynne; Joyce, Peter R.
A study of 73 New Zealand women attending a sexual abuse program found that posttraumatic stress disorder (PTSD) symptoms were associated with higher levels of all psychopathology. However, the severity of PTSD symptoms was also associated with the extent of abuse which involved actual sexual intercourse. (Author/CR)
Borowa, Dominika; Robitschek, Christine; Harmon, Kevin Andrew; Shigemoto, Yuki
Objective: This study explored the extent to which personal growth initiative (PGI) may predict posttraumatic stress and growth in student service members/veterans (SSM/V). Participants: Participants were 136 SSM/V (79% men) representing multiple branches of the armed forces. Forty-four percent of participants reported having combat experience.…
Post-traumatic stress disorder (PTSD) is a maladaptive and debilitating anxiety disorder which may affect up to 40% of individuals over lifetime exposure to traumatic event. The aim of this case-report is to highlight the use of furosemide, alone or in combination, in PTSD associated with sexual assault. Low-dose furosemide ...
Hendriks, G.J.; Minnen, A. van
Two patients, a boy aged 19 years and a girl aged 16 years, were diagnosed to be suffering from a posttraumatic stress disorder (PTSD) 7 and 2 years after sexual abuse, respectively. There was thus a serious delay in the correct diagnosis and the start of cognitive behavioural therapy, which was
Kearney, Christopher A.; Wechsler, Adrianna; Kaur, Harpreet; Lemos-Miller, Amie
Youths who have been maltreated often experience symptoms of posttraumatic stress disorder (PTSD), and this special population has received increased attention from researchers. Pathways toward maladaptive effects of maltreatment and PTSD are remarkably similar and reflect specific biological diatheses and psychological vulnerabilities that…
Poljac, E.; Montagne, B.; Haan, E.H.F. de
Post-traumatic stress disorder (PTSD) is associated with impairments in emotional experience and expression. The current study examined the recognition of emotional facial expressions in PTSD patients and matched healthy controls, both in terms of accuracy and sensitivity. The task involved short
Lommen, Miriam J.J.; Grey, Nick; Clark, David M.; Wild, Jennifer; Stott, Richard; Ehlers, Anke
BackgroundMost patients with posttraumatic stress disorder (PTSD) suffer from sleep problems. Concerns have been raised about possible detrimental effects of sleep problems on the efficacy of psychological treatments for PTSD. In this study, we investigated the relation of session-to-session changes
Rønholt, Stine; Karsberg, Sidsel; Elklit, Ask
Background: In 2004, a firework factory in a residential area of a large Danish city exploded. The children at the local school were screened for symptoms of posttraumatic stress disorder (PTSD) 16 months and 3½ years after the incident. A large proportion of the children still suffered from a substantial number of symptoms 3½ years after the…
Kleim, Birgit; Grey, Nick; Wild, Jennifer; Nussbeck, Fridtjof W.; Stott, Richard; Hackmann, Ann; Clark, David M.; Ehlers, Anke
Objective: There is a growing body of evidence for the effectiveness of trauma-focused cognitive behavior therapy (TF-CBT) for posttraumatic stress disorder (PTSD), but few studies to date have investigated the mechanisms by which TF-CBT leads to therapeutic change. Models of PTSD suggest that a core treatment mechanism is the change in…
Smid, G.; van der Velden, P.G.; Gersons, B.P.R.; Kleber, R.J.
In disaster survivors, the occurrence of mental health problems beyond the immediate aftermath of the disaster has repeatedly been reported. The aim of the present study was to evaluate the course of symptoms and mental health services (MHS) utilization in late-onset posttraumatic stress disorder
antidepres- sants, benzodiazepines and other anxiolytic drugs, The Relationship Between Gabapentin and Pregabalin and Posttraumatic Stress Disorder...Gabapentin and pregabalin are anticonvulsant drugs that limited evidence suggests may also be effective treatments for some psychological disorders. This...dates were collected. Subjects were grouped based on receipt of gabapentin or pregabalin , and the groups were compared. The primary outcome was
Bratt, Avery; And Others
The high incidence of reported posttraumatic stress disorder (PTSD) among Vietnam veterans has prompted researchers to search for reliable assessment and treatment procedures for this disorder. Although some encouraging preliminary data on the use of the Minnesota Multiphasic Personality Inventory (MMPI) have been obtained, it is uncertain if this…
Keane, Terence M.; And Others
Developed empirically based criteria for use of the Minnesota Multiphasic Personality Inventory (MMPI) to aid in the assessment and diagnosis of Posttraumatic Stress Disorder (PTSD) in patients (N=200). Analysis based on an empircally derived decision rule correctly classified 74 percent of the patients in each group. (LLL)
Foy, David W.; And Others
Examined the influence of premilitary adjustment, military adjustment, and combat experience on the development of posttraumatic stress disorder in 43 Vietnam veterans. Results showed combat exposure was the most significant predictor, followed by military adjustment. The Minnesota Multiphasic Personality Inventory appeared to offer promise for…
de Vries, Giel-Jan; Olff, Miranda
Little information exists on the life time prevalence of traumatic events and posttraumatic stress disorder (PTSD) in the general population of the Netherlands. A national representative sample of 1087 adults aged 18 to 80 years was selected using random digit dialing and then surveyed by telephone
Weems, Carl F.; Pina, Armando A.; Costa, Natalie M.; Watts, Sarah E.; Taylor, Leslie K.; Cannon, Melinda F.
On the basis of theory and previous research, it was hypothesized that predisaster child trait anxiety would predict disaster-related posttraumatic stress symptoms and generalized anxiety disorder symptoms, even after controlling for the number of hurricane exposure events. Results support this hypothesis and further indicate that predisaster…
Mohay, Heather; Forbes, Nicole
A significant number of children suffer long-term psychological disturbance following exposure to a natural disaster. Evidence suggests that a dose-response relationship exists, so that children and adolescents who experience the most intense or extensive exposure to the risk factors for posttraumatic stress disorder (PTSD) are likely to develop…
Ehring, Thomas; Welboren, Renate; Morina, Nexhmedin; Wicherts, Jelte M.; Freitag, Janina; Emmelkamp, Paul M. G.
Posttraumatic stress disorder (PTSD) is highly prevalent in adult survivors of childhood sexual and/or physical abuse. However, intervention studies focusing on this group of patients are underrepresented in earlier meta-analyses on the efficacy of PTSD treatments. The current meta-analysis
Twohig, Michael P.
An adult woman with chronic posttraumatic stress disorder (PTSD) and major depressive disorder who was nonresponsive to 20 sessions of cognitive behavior therapy (CBT) is presented in this case study. Two months after her CBT trial, she was treated with 21 sessions of Acceptance and Commitment Therapy (ACT) for PTSD. Measurements of PTSD severity,…
Schaal, Susanne; Dusingizemungu, Jean-Pierre; Jacob, Nadja; Neuner, Frank; Elbert, Thomas
A number of studies have demonstrated that symptoms of prolonged grief disorder (PGD) represent a symptom cluster distinct from bereavement-related depression, anxiety, and posttraumatic stress disorder (PTSD). The aim of the present study was to confirm and extend these findings using the most recent criteria defining PGD. The authors interviewed…
Landolt, Markus A.; Vollrath, Margarete; Laimbacher, Joseph; Gnehm, Hanspeter E.; Sennhauser, Felix H.
Objective: To determine the prevalence, course, and predictors of posttraumatic stress disorder (PTSD) in mothers and fathers of children with newly diagnosed type 1 diabetes. Method: Forty-nine mothers and 48 fathers of 52 children (response rate 65%) with newly diagnosed diabetes (age 6.5-15 years) were assessed at 6 weeks, 6 months, and 12…
Casey, Laura Baylot; Zanksas, Steve; Meindl, James N.; Parra, Gilbert R.; Cogdal, Pam; Powell, Kevin
Posttraumatic stress symptoms (PTSS) are well documented in parents of children diagnosed with chronic disabilities and life-threatening illnesses. The occurrence of PTSS in parents of children with autism spectrum disorders (autism) has not been directly linked but instead only mentioned without data supporting the claim. This research was a…
Day, Kristen W.
In this article, the author proposes an integration of existential and narrative therapies with current evidence-supported approaches to treating the aforementioned population. First, she briefly defines interpersonal violence, then provides a history and review of the diagnostic criteria for Posttraumatic Stress Disorder (PTSD), which frequently…
Straker, G.; Moosa, F.
Posttraumatic Stress Disorder developed in many youths who were exposed to multiple trauma in South Africa's black townships. A modified treatment program was developed for 60 youths, with the goals of alleviating symptoms, documenting events for court cases, and helping individuals reevaluate their position in the struggle against apartheid. (JDD)
Eekhout, Iris; Reijnen, Alieke; Vermetten, Eric; Geuze, Elbert
Deployment can put soldiers at risk of developing post-traumatic stress symptoms. Despite several longitudinal studies, little is known about the timing of an increase in post-traumatic stress symptoms relative to pre-deployment. Longitudinal studies starting pre-deployment, in which participants are repeatedly measured over time, are warranted to assess the timing of an increase in symptoms to ultimately assess the timing of an increase in treatment demand after deployment. In this large observational cohort study, Dutch military personnel who were deployed to Afghanistan as part of the International Security Assistance Forces between March, 2005, and September, 2008, were assessed for post-traumatic stress symptoms with the Self-Rating Inventory for Post-traumatic Stress Disorder (SRIP) questionnaire. Participants were assessed 1 month before deployment and followed up at 1 month, 6 months, 12 months, 2 years, and 5 years after deployment, with changes in SRIP scores compared with pre-deployment using a mixed model analysis. The primary outcome was the total score of post-traumatic stress symptoms measured with SRIP at pre-deployment and the five follow-up assessments, with a score of 38 used as the cutoff to indicate substantial post-traumatic stress symptoms. Between March, 2005, and September, 2008, 1007 participants were recruited to this study. The results show two important effects of deployment on post-traumatic stress symptoms. A short-term symptom increase within the first 6 months after deployment (symptom increase coefficient for SRIP score vs pre-deployment [β] 0·99, 95% CI 0·50-1·48); and a long-term symptom increase at 5 years after deployment (β 1·67, 1·14-2·20). This study underlines the importance of long-term monitoring of the psychological health of soldiers after deployment because early detection of symptoms is essential to early treatment, which is related to improved psychological health. Dutch Ministry of Defense. Copyright © 2016