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Sleep Medicine Clinics Sep 2018Sleep disorders are common among women veterans and contribute to poor functioning and quality of life. Studies show that women veterans are particularly prone to... (Review)
Review
Sleep disorders are common among women veterans and contribute to poor functioning and quality of life. Studies show that women veterans are particularly prone to insomnia, sleep-disordered breathing, and insufficient sleep. Standard cognitive behavioral therapy for insomnia (CBT-I) should be viewed as first-line therapy for insomnia disorder, and women veterans should be screened and treated for sleep-disordered breathing. Behavioral and lifestyle factors contributing to insufficient sleep should also be addressed. Challenges exist in diagnosing and treating sleep disorders in women veterans, in part because of high rates of psychiatric comorbidities, such as posttraumatic stress disorder and depression.
Topics: Adult; Cognitive Behavioral Therapy; Comorbidity; Depressive Disorder; Female; Humans; Sleep Wake Disorders; Stress Disorders, Post-Traumatic; Veterans
PubMed: 30098757
DOI: 10.1016/j.jsmc.2018.04.010 -
Revista Brasileira de Psiquiatria (Sao... 2018There is growing evidence supporting the association between migration and posttraumatic stress disorder (PTSD). Considering the growing population of migrants and the... (Review)
Review
OBJECTIVE
There is growing evidence supporting the association between migration and posttraumatic stress disorder (PTSD). Considering the growing population of migrants and the particularities of providing culturally sensitive mental health care for these persons, clinicians should be kept up to date with the latest information regarding this topic. The objective of this study was to critically review the literature regarding migration, trauma and PTSD, and mental health services.
METHODS
The PubMed, SciELO, LILACS, and ISI Web of Science databases were searched for articles published in Portuguese, English, Spanish, or French, and indexed from inception to 2017. The following keywords were used: migration, mental health, mental health services, stress, posttraumatic stress disorder, and trauma.
RESULTS
Migration is associated with specific stressors, mainly related to the migratory experience and to the necessary process of acculturation occurring in adaptation to the host country. These major stressors have potential consequences in many areas, including mental health. The prevalence of PTSD among migrants is very high (47%), especially among refugees, who experience it at nearly twice the rate of migrant workers.
CONCLUSIONS
Mental health professionals must be trained to recognize and provide appropriate care for posttraumatic and/or stress-related disorders among migrants.
Topics: Acculturation; Brazil; Health Personnel; Humans; Mental Health; Mental Health Services; Refugees; Stress Disorders, Post-Traumatic; Transients and Migrants
PubMed: 29069252
DOI: 10.1590/1516-4446-2017-2290 -
American Journal of Obstetrics and... Jun 2024Women can develop posttraumatic stress disorder in response to experienced or perceived traumatic, often medically complicated, childbirth; the prevalence of these... (Meta-Analysis)
Meta-Analysis Review
OBJECTIVE
Women can develop posttraumatic stress disorder in response to experienced or perceived traumatic, often medically complicated, childbirth; the prevalence of these events remains high in the United States. Currently, no recommended treatment exists in routine care to prevent or mitigate maternal childbirth-related posttraumatic stress disorder. We conducted a systematic review and meta-analysis of clinical trials that evaluated any therapy to prevent or treat childbirth-related posttraumatic stress disorder.
DATA SOURCES
PsycInfo, PsycArticles, PubMed (MEDLINE), ClinicalTrials.gov, CINAHL, ProQuest, Sociological Abstracts, Google Scholar, Embase, Web of Science, ScienceDirect, Scopus, and the Cochrane Central Register of Controlled Trials (CENTRAL) were searched for eligible trials published through September 2023.
STUDY ELIGIBILITY CRITERIA
Trials were included if they were interventional, if they evaluated any therapy for childbirth-related posttraumatic stress disorder for the indication of symptoms or before posttraumatic stress disorder onset, and if they were written in English.
METHODS
Independent coders extracted the sample characteristics and intervention information of the eligible studies and evaluated the trials using the Downs and Black's quality checklist and Cochrane's method for risk of bias evaluation. Meta-analysis was conducted to evaluate pooled effect sizes of secondary and tertiary prevention trials.
RESULTS
A total of 41 studies (32 randomized controlled trials, 9 nonrandomized trials) were reviewed. They evaluated brief psychological therapies including debriefing, trauma-focused therapies (including cognitive behavioral therapy and expressive writing), memory consolidation and reconsolidation blockage, mother-infant-focused therapies, and educational interventions. The trials targeted secondary preventions aimed at buffering childbirth-related posttraumatic stress disorder usually after traumatic childbirth (n=24), tertiary preventions among women with probable childbirth-related posttraumatic stress disorder (n=14), and primary prevention during pregnancy (n=3). A meta-analysis of the combined randomized secondary preventions showed moderate effects in reducing childbirth-related posttraumatic stress disorder symptoms when compared with usual treatment (standardized mean difference, -0.67; 95% confidence interval, -0.92 to -0.42). Single-session therapy within 96 hours of birth was helpful (standardized mean difference, -0.55). Brief, structured, trauma-focused therapies and semi-structured, midwife-led, dialogue-based psychological counseling showed the largest effects (standardized mean difference, -0.95 and -0.91, respectively). Other treatment approaches (eg, the Tetris game, mindfulness, mother-infant-focused treatment) warrant more research. Tertiary preventions produced smaller effects than secondary prevention but are potentially clinically meaningful (standardized mean difference, -0.37; -0.60 to -0.14). Antepartum educational approaches may help, but insufficient empirical evidence exists.
CONCLUSION
Brief trauma-focused and non-trauma-focused psychological therapies delivered early in the period following traumatic childbirth offer a critical and feasible opportunity to buffer the symptoms of childbirth-related posttraumatic stress disorder. Future research that integrates diagnostic and biological measures can inform treatment use and the mechanisms at work.
Topics: Humans; Stress Disorders, Post-Traumatic; Female; Pregnancy; Parturition; Cognitive Behavioral Therapy
PubMed: 38122842
DOI: 10.1016/j.ajog.2023.12.013 -
Current Sports Medicine Reports Dec 2021Posttraumatic stress disorder (PTSD), which may develop following exposure to severe trauma, can occur in all people at any age. PTSD affects approximately 10 million...
Posttraumatic stress disorder (PTSD), which may develop following exposure to severe trauma, can occur in all people at any age. PTSD affects approximately 10 million Americans, with an incidence of approximately 3.5% diagnosed every year. Elite athletes are not immune to posttraumatic stress. While difficult to precisely quantify, an estimated 1 in 8 elite athletes suffers from PTSD. Because of its complex presentation, PTSD can be challenging to diagnose and effectively treat in athletes. Several barriers unique to elite athletes exist which may inadvertently delay or prevent access to the appropriate clinical experts. Several best practice models for mental health screening in elite athletes have been developed in the past decade. Treatment of PTSD in the athlete population is similar to trauma-informed treatment in the general population, but should involve the athlete's multidisciplinary team of clinical experts to account for unique demands and preferences in the context of sport.
Topics: Athletes; Humans; Mass Screening; Sports; Stress Disorders, Post-Traumatic
PubMed: 34882121
DOI: 10.1249/JSR.0000000000000918 -
Biological Psychiatry May 2018Posttraumatic stress disorder (PTSD) is a pathologic response to trauma that impacts ∼8% of the population and is highly comorbid with other disorders, such as... (Review)
Review
Posttraumatic stress disorder (PTSD) is a pathologic response to trauma that impacts ∼8% of the population and is highly comorbid with other disorders, such as traumatic brain injury. PTSD affects multiple biological systems throughout the body, including the hypothalamic-pituitary-adrenal axis, cortical function, and the immune system, and while the study of the biological underpinnings of PTSD and related disorders are numerous, the roles of noncoding RNAs (ncRNAs) are just emerging. Moreover, deep sequencing has revealed that ncRNAs represent most of the transcribed mammalian genome. Here, we present developing evidence that ncRNAs are involved in critical aspects of PTSD pathophysiology. In that regard, we summarize the roles of three classes of ncRNAs in PTSD and related disorders: microRNAs, long-noncoding RNAs, and retrotransposons. This review evaluates findings from both animal and human studies with a special focus on the role of ncRNAs in hypothalamic-pituitary-adrenal axis abnormalities and glucocorticoid dysfunction in PTSD and traumatic brain injury. We conclude that ncRNAs may prove to be useful biomarkers to facilitate personalized medicines for trauma-related brain disorders.
Topics: Glucocorticoids; Humans; Precision Medicine; RNA, Untranslated; Stress Disorders, Post-Traumatic; Stress, Psychological
PubMed: 29559087
DOI: 10.1016/j.biopsych.2018.01.009 -
Journal of Traumatic Stress Jun 2023This article introduces the special section in the Journal of Traumatic Stress focused on social relationships and their connection to treatment among individuals with...
This article introduces the special section in the Journal of Traumatic Stress focused on social relationships and their connection to treatment among individuals with posttraumatic stress disorder (PTSD). Interpersonal relationships have the potential to influence treatment-seeking, retention, and outcomes. For individuals with PTSD, social relationships have long been understood to be intimately and bidirectionally tied to symptom levels. In light of somewhat modest rates of treatment response to current first-line interventions for PTSD, there is growing interest in engaging these relationships, as well as relationship-relevant beliefs and behaviors, to enhance PTSD treatment. This introductory article frames the rationale for examining these social factors to better understand and improve treatments and provides an overview of the collection of articles contained herein.
Topics: Humans; Interpersonal Relations; Stress Disorders, Post-Traumatic
PubMed: 36853594
DOI: 10.1002/jts.22922 -
The Nursing Clinics of North America Jun 2016Although trauma exposure is common, few people develop acute and chronic psychiatric disorders. Those who develop posttraumatic stress disorder likely have coexisting... (Review)
Review
Although trauma exposure is common, few people develop acute and chronic psychiatric disorders. Those who develop posttraumatic stress disorder likely have coexisting psychiatric and physical disorders. Psychiatric nurses must be knowledgeable about trauma responses, implement evidence-based approaches to conduct assessments, and create safe environments for patients. Most researchers assert that trauma-focused cognitive-behavioral approaches demonstrate the most efficacious treatment outcomes. Integrated approaches, offer promising treatment options. This article provides an overview of clinical factors necessary to help the trauma survivor begin the process of healing and recovery and attain an optimal level of functioning.
Topics: Evidence-Based Nursing; Female; Humans; Internal-External Control; Male; Nurse's Role; Nursing Assessment; Psychiatric Nursing; Stress Disorders, Post-Traumatic; Survivors
PubMed: 27229285
DOI: 10.1016/j.cnur.2016.01.014 -
Journal of Evidence-informed Social Work 2016Physiological symptoms of posttraumatic stress disorder (PTSD) manifest as increased arousal and reactivity seen as anger outburst, irritability, reckless behavior with... (Review)
Review
Physiological symptoms of posttraumatic stress disorder (PTSD) manifest as increased arousal and reactivity seen as anger outburst, irritability, reckless behavior with no concern for consequences, hypervigilance, sleep disturbance, and problems with focus (American Psychiatric Association, 2013 ). In seeking the most beneficial treatment for PTSD, consideration must be given to the anxiety response. Relaxation techniques are shown to help address the physiological manifestations of prolonged stress. The techniques addressed by the authors in this article include mindfulness, deep breathing, yoga, and meditation. By utilizing these techniques traditional therapies can be complemented. In addition, those who are averse to the traditional evidence-based practices or for those who have tried traditional therapies without success; these alternative interventions may assist in lessening physiological manifestations of PTSD. Future research studies assessing the benefits of these treatment modalities are warranted to provide empirical evidence to support the efficacy of these treatments.
Topics: Breathing Exercises; Humans; Meditation; Mind-Body Therapies; Mindfulness; Relaxation Therapy; Stress Disorders, Post-Traumatic
PubMed: 27119722
DOI: 10.1080/23761407.2016.1166845 -
Trends in Psychiatry and Psychotherapy 2017Earthquakes are unpredictable and devastating natural disasters. They can cause massive destruction and loss of life and survivors may suffer psychological symptoms of... (Review)
Review
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.
Topics: Disasters; Earthquakes; Humans; Stress Disorders, Post-Traumatic; Survivors
PubMed: 28700042
DOI: 10.1590/2237-6089-2016-0029 -
Neuroscience Letters May 2017
Topics: Animals; Antidepressive Agents; Brain; Humans; Stress Disorders, Post-Traumatic
PubMed: 28478864
DOI: 10.1016/j.neulet.2017.04.046