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Psychological Trauma : Theory,... Jan 2024Psychopathology, cyberpsychology, and mass media theories link psychological symptoms, such as posttraumatic stress disorder (PTSD), to increased media and technology...
OBJECTIVE
Psychopathology, cyberpsychology, and mass media theories link psychological symptoms, such as posttraumatic stress disorder (PTSD), to increased media and technology usage (MTU). Given limited research in this area, we uniquely examined if specific MTU facets were associated with PTSD symptom severity.
METHOD
A sample of 404 socioeconomically diverse adults ( = 35.89; 57.4% female) was recruited from Amazon's Mechanical Turk and completed the Life Events Checklist for , Posttraumatic Stress Disorder Checklist for , Media and Technology Usage and Attitudes Scale, and Patient Health Questionnaire-9.
RESULTS
Hierarchical multiple regression analyses indicated that, controlling for depression severity, greater frequency of TV viewing ( = .004) and media sharing ( = .040) and greater quantity of online friendships ( = .006) were associated with greater PTSD symptom severity.
CONCLUSION
Study findings suggest that the extent of MTU behaviors (especially extent of TV use, media sharing, and online friendships) are important to examine in trauma-exposed individuals with PTSD symptoms. Results generalize to trauma-exposed community members and are considered within the context of current MTU theories. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
Topics: Adult; Humans; Female; Male; Stress Disorders, Post-Traumatic; Psychopathology; Diagnostic and Statistical Manual of Mental Disorders; Regression Analysis
PubMed: 35939610
DOI: 10.1037/tra0001333 -
Current Neuropharmacology 2024We conducted a scientometric analysis to outline clinical research on posttraumatic stress disorder (PTSD). Our primary objective was to perform a broad-ranging...
We conducted a scientometric analysis to outline clinical research on posttraumatic stress disorder (PTSD). Our primary objective was to perform a broad-ranging scientometric analysis to evaluate key themes and trends over the past decades. Our secondary objective was to measure research network performance. We conducted a systematic search in the Web of Science Core Collection up to 15 August 2022 for publications on PTSD. We identified 42,170 publications published between 1945 and 2022. We used CiteSpace to retrieve the co-cited reference network (1978-2022) that presented significant modularity and mean silhouette scores, indicating highly credible clusters (Q = 0.915, S = 0.795). Four major trends of research were identified: 'war veterans and refugees', 'treatment of PTSD/neuroimaging', 'evidence syntheses', and 'somatic symptoms of PTSD'. The largest cluster of research concerned evidence synthesis for genetic predisposition and environmental exposures leading to PTSD occurrence. Research on war-related trauma has shifted from battlefield-related in-person exposure trauma to drone operator trauma and is being out published by civilian-related trauma research, such as the 'COVID-19' pandemic impact, 'postpartum', and 'grief disorder'. The focus on the most recent trends in the research revealed a burst in the 'treatment of PTSD' with the development of Mhealth, virtual reality, and psychedelic drugs. The collaboration networks reveal a central place for the USA research network, and although relatively isolated, a recent surge of publications from China was found. Compared to other psychiatric disorders, we found a lack of high-quality randomized controlled trials for pharmacological and nonpharmacological treatments. These results can inform funding agencies and future research.
Topics: Humans; Stress Disorders, Post-Traumatic; Genetic Predisposition to Disease
PubMed: 37888890
DOI: 10.2174/1570159X22666230927143106 -
The Journal of Neuropsychiatry and... 2023Patients with functional neurological symptom disorder (FNSD) report high rates of traumatization and have high levels of posttraumatic stress disorder (PTSD) symptoms....
OBJECTIVE
Patients with functional neurological symptom disorder (FNSD) report high rates of traumatization and have high levels of posttraumatic stress disorder (PTSD) symptoms. Psychotherapy is a mainstay of treatment for persons with FNSD. In this study, the investigators explored changes in PTSD symptoms and health-related quality of life after psychotherapy among persons with FNSD and examined factors contributing to these changes.
METHODS
Data were prospectively collected for patients with FNSD attending a specialist outpatient psychotherapy service in the United Kingdom (N=210) as part of an ongoing routine service evaluation. Pre- and posttherapy questionnaires included self-report measures of PTSD symptoms (Posttraumatic Stress Disorder Checklist-Civilian version), depressive symptoms (Patient Health Questionnaire-9), anxiety symptoms (General Anxiety Disorder-7 scale), somatic symptoms (Patient Health Questionnaire-15), health-related quality of life (Short-Form Health Survey-36), and social functioning (Work and Social Adjustment Scale). Independent contributions to psychotherapy-related changes in PTSD symptoms and health-related quality of life were explored through multivariate analyses.
RESULTS
All outcome measures revealed improvements after psychotherapy (p<0.001). Psychotherapy-related changes in depression and somatic symptoms and employment status at baseline explained 51% of the variance in PTSD symptom changes. Changes in PTSD symptoms, depressive symptoms, and somatic symptoms made independent contributions to improvements in health-related quality of life (R=0.54). Improvements were unrelated to FNSD subtype (dissociative seizures or other FNSD), age, marital status, or number of sessions attended.
CONCLUSIONS
Reductions in self-reported PTSD, depressive, anxiety, and somatic symptoms, as well as improved health-related quality of life, were observed among patients who received one or more sessions of psychotherapy. Randomized controlled trials of psychotherapy for patients with FNSD are warranted.
Topics: Humans; Stress Disorders, Post-Traumatic; Quality of Life; Medically Unexplained Symptoms; Psychotherapy; Anxiety Disorders
PubMed: 37089075
DOI: 10.1176/appi.neuropsych.21070184 -
Journal of Affective Disorders Jul 2023In this systematic review and meta-analysis, we aimed to provide a comprehensive overview of gray matter alterations of adult- and underage patients with posttraumatic... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
In this systematic review and meta-analysis, we aimed to provide a comprehensive overview of gray matter alterations of adult- and underage patients with posttraumatic stress disorder (PTSD) in comparison to healthy trauma-exposed (TC) and non-exposed (HC) individuals.
METHODS
We subdivided our groups into patients with PTSD after trauma exposure in adulthood (aa) or childhood (ac) as well as children with PTSD (cc). We identified 113 studies, including 6.800 participants in our review, which we divided into studies focusing on whole-brain and region-of-interest (ROI) analysis. We performed a coordinate-based meta-analysis on 14 studies in the group of aa-PTSD.
RESULTS
We and found lower gray matter volume in patients with PTSD (aa) in the medial frontal gyrus (PTSD
LIMITATIONS
Due to a limited number of studies reporting whole-brain results, the meta-analyses could only be performed in one subgroup and within this subgroup for a limited number of studies.
CONCLUSIONS
Our results are in line with psychobiological models of PTSD that associate the identified regions with brain circuits involved in context processing, threat detection and emotion regulation.
Topics: Humans; Adult; Child; Gray Matter; Stress Disorders, Post-Traumatic; Magnetic Resonance Imaging; Cerebral Cortex; Brain
PubMed: 37086802
DOI: 10.1016/j.jad.2023.04.028 -
Journal of Urban Health : Bulletin of... Oct 2023Using the Future of Families and Child Wellbeing Study (N = 785), this article considers the ramifications of police use of racial slurs, a type of intrusive...
Using the Future of Families and Child Wellbeing Study (N = 785), this article considers the ramifications of police use of racial slurs, a type of intrusive behavior, toward minority youth for posttraumatic stress (PTS). We also examine whether other intrusive police behaviors exacerbate this relationship and test whether perceptions of injustice mediate it. Results indicated that hearing a police officer use a racial slur was positively associated with PTS after controlling for intrusive police behaviors and other covariates. Intrusive policing tended to co-occur with the use of racial slurs and was positively associated with PTS. The association between hearing a racial slur and PTS did not vary by the number of intrusive behaviors exhibited by police. The association between hearing a slur and PTS was partially mediated by perceived procedural injustice. Overall, the use of racial slurs by police may do harm to minority adolescents by putting them at risk for posttraumatic stress disorder. Our results are consistent with prior research that racial slurs may contribute to PTS by eroding the bounds of what is considered just and fair. Interestingly, the association between racial slurs and PTS was independent of other intrusive policing behaviors. Mental health screeners should ask not only about being stopped by police but the characteristics of that encounter as well - including those imbued with racial animus.
Topics: Adolescent; Humans; Mental Health; Minority Groups; Police; Racial Groups; Stress Disorders, Post-Traumatic
PubMed: 37626221
DOI: 10.1007/s11524-023-00747-6 -
Biological Psychiatry Aug 2023There is high comorbidity of posttraumatic stress disorder (PTSD) and alcohol use disorder with few effective treatment options. Animal models of PTSD have shown...
BACKGROUND
There is high comorbidity of posttraumatic stress disorder (PTSD) and alcohol use disorder with few effective treatment options. Animal models of PTSD have shown increases in alcohol drinking, but effects of stress history on subsequent vulnerability to alcohol relapse have not been examined. Here we present a mouse model of PTSD involving chronic multimodal stress exposure that resulted in long-lasting sensitization to stress-induced alcohol relapse, and this sensitized stress response was blocked by oxytocin (OT) administration.
METHODS
Male and female mice trained to self-administer alcohol were exposed to predator odor (TMT) + yohimbine over 5 consecutive days or left undisturbed. After reestablishing stable alcohol responding/intake, mice were tested under extinction conditions, and then all mice were exposed to TMT or context cues previously associated with TMT before a reinstatement test session. Separate studies examined messenger RNA expression of Oxt and Oxtr in hypothalamus following chronic stress exposure. A final study examined the effects of systemic administration of OT on stress-induced alcohol relapse in mice with and without a history of chronic stress experience.
RESULTS
Chronic stress exposure produced long-lasting sensitization to subsequent stress-induced alcohol relapse that also generalized to stress-related context cues and transcriptional changes in hypothalamic OT system. OT injected before the reinstatement test session completely blocked the sensitized stress-induced alcohol relapse effect.
CONCLUSIONS
Collectively, these results provide support for the therapeutic potential of OT, along with highlighting the value of utilizing this model in evaluating other pharmacological interventions for treatment of PTSD/alcohol use disorder comorbidity.
Topics: Male; Mice; Female; Animals; Alcoholism; Oxytocin; Stress Disorders, Post-Traumatic; Ethanol; Alcohol Drinking; Comorbidity
PubMed: 36822933
DOI: 10.1016/j.biopsych.2022.12.003 -
BMJ Military Health Jan 2024Moral injury is a relatively new, but increasingly studied, construct in the field of mental health, particularly in relation to current and ex-serving military... (Review)
Review
Moral injury is a relatively new, but increasingly studied, construct in the field of mental health, particularly in relation to current and ex-serving military personnel. Moral injury refers to the enduring psychosocial, spiritual or ethical harms that can result from exposure to high-stakes events that strongly clash with one's moral beliefs. There is a pressing need for further research to advance understanding of the nature of moral injury; its relationship to mental disorders such as posttraumatic stress disorder and depression; triggering events and underpinning mechanisms; and prevalence, prevention and treatment. In the meantime, military leaders have an immediate need for guidance on how moral injury should be addressed and, where possible, prevented. Such guidance should be theoretically sound, evidence-informed and ethically responsible. Further, the implementation of any practice change based on the guidance should contribute to the advancement of science through robust evaluation. This paper draws together current research on moral injury, best-practice approaches in the adjacent field of psychological resilience, and principles of effective implementation and evaluation. This research is combined with the military and veteran mental health expertise of the authors to provide guidance on the design, implementation and evaluation of moral injury interventions in the military. The paper discusses relevant training in military ethical practice, as well as the key roles leaders have in creating cohesive teams and having frank discussions about the moral and ethical challenges that military personnel face.
Topics: Humans; Military Personnel; Stress Disorders, Post-Traumatic; Veterans; Morals; Prevalence
PubMed: 35705259
DOI: 10.1136/bmjmilitary-2022-002128 -
Stroke Apr 2024There is limited research on outcomes of patients with posttraumatic stress disorder (PTSD) who also develop stroke, particularly regarding racial disparities. Our goal...
BACKGROUND
There is limited research on outcomes of patients with posttraumatic stress disorder (PTSD) who also develop stroke, particularly regarding racial disparities. Our goal was to determine whether PTSD is associated with the risk of hospital readmission after stroke and whether racial disparities existed.
METHODS
The analytical sample consisted of all veterans receiving care in the Veterans Health Administration who were identified as having a new stroke requiring inpatient admission based on the codes. PTSD and comorbidities were identified using the codes and given the date of first occurrence. The retrospective cohort data were obtained from the Veterans Affairs Corporate Data Warehouse. The main outcome was any readmission to Veterans Health Administration with a stroke diagnosis. The hypothesis that PTSD is associated with readmission after stroke was tested using Cox regression adjusted for patient characteristics including age, sex, race, PTSD, smoking status, alcohol use, and comorbidities treated as time-varying covariates.
RESULTS
Our final cohort consisted of 93 651 patients with inpatient stroke diagnosis and no prior Veterans Health Administration codes for stroke starting from 1999 with follow-up through August 6, 2022. Of these patients, 12 916 (13.8%) had comorbid PTSD. Of the final cohort, 16 896 patients (18.0%) with stroke were readmitted. Our fully adjusted model for readmission found an interaction between African American veterans and PTSD with a hazard ratio of 1.09 ([95% CI, 1.00-1.20] =0.047). In stratified models, PTSD has a significant hazard ratio of 1.10 ([95% CI, 1.02-1.18] =0.01) for African American but not White veterans (1.05 [95% CI, 0.99-1.11]; =0.10).
CONCLUSIONS
Among African American veterans who experienced stroke, preexisting PTSD was associated with increased risk of readmission, which was not significant among White veterans. This study highlights the need to focus on high-risk groups to reduce readmissions after stroke.
Topics: Humans; United States; Stress Disorders, Post-Traumatic; Retrospective Studies; Patient Readmission; Stroke; Comorbidity; Veterans
PubMed: 38482715
DOI: 10.1161/STROKEAHA.123.044795 -
Administration and Policy in Mental... Sep 2023Guidelines strongly recommend trauma-focused therapies to treat posttraumatic stress disorder. Implementation of cognitive processing therapy (CPT) and prolonged...
Guidelines strongly recommend trauma-focused therapies to treat posttraumatic stress disorder. Implementation of cognitive processing therapy (CPT) and prolonged exposure (PE) in Veterans Health Administration (VHA) and non-VHA settings began in 2006. We conducted a systematic review of implementation facilitators and challenges and strategies to address barriers. We searched MEDLINE, Embase, PsycINFO, and CINAHL from inception until March 2021 for English-language articles. Two individuals reviewed eligibility and rated quality. Quantitative results were abstracted by one reviewer and verified by a second. Qualitative results were independently coded by two reviewers and finalized through consensus. We used RE-AIM and CFIR frameworks to synthesize findings. 29 eligible studies addressed CPT/PE, mostly conducted in VHA. Training/education with audit/feedback was the primary implementation strategy and was linked to improved provider CPT/PE perceptions and self-efficacy. Use was not widespread. Only six studies tested other implementation strategies with mixed impact. Following VHA implementation, strong support for training, perceived effectiveness for patients and benefits for clinics, and positive patient experiences and relationships with providers were reported. However, barriers persisted including perceived protocol inflexibility, complex referral processes and patient complexity and competing needs. In non-VHA settings, providers perceived fewer barriers, but few were CPT/PE trained. Across both settings, fewer studies targeted patient factors. Training/education with audit/feedback improved perceptions and the availability of CPT/PE, but not consistent use. Studies testing implementation strategies to address post-training challenges, including patient-level factors, are needed. A few studies are underway in VHA to test patient-focused and other implementation strategies. Research assessing actual vs perceived barriers in non-VHA settings is needed to elucidate unique challenges experienced.
Topics: United States; Humans; Stress Disorders, Post-Traumatic; United States Department of Veterans Affairs; Cognitive Behavioral Therapy; Educational Status; Implosive Therapy
PubMed: 37326899
DOI: 10.1007/s10488-023-01279-6 -
Journal of Community Health Oct 2023While severity of post-traumatic stress disorder (PTSD) symptoms and moral injury among civilians affected by armed conflicts is generally understudied, even less...
While severity of post-traumatic stress disorder (PTSD) symptoms and moral injury among civilians affected by armed conflicts is generally understudied, even less research exists on civilian populations during an active war. This paper reports a large-scale study that administered standard assessments of PTSD and moral injury severity, as well as rich demographic questionnaires, to nearly 1300 Ukrainian civilians during the ongoing Russian invasion. Analyses revealed an extremely high prevalence of severe PTSD symptoms and moral injury, relative to both proposed clinical cut-offs and to earlier measurements from a similar population. Further regression analyses identified risk factors and protective factors. Greater severity of PTSD symptoms was observed among women, older and forcibly displaced individuals, and individuals from geographic regions under Russian occupation. Higher education correlated with milder PTSD symptoms. Moral injury was particularly strong in younger individuals. The present study is one of the first to report a large scale set of psychological data collected from the civilian population of Ukraine during the ongoing Russian invasion. It is obvious from the scope and long-term nature of the atrocities that psychological treatment of the civilian population will be required both presently, while the hostilities are ongoing, and in the future. This data contributes to a detailed understanding of the psychological response to traumatic stress, including its overall prevalence and presence in specific demographically and geographically defined civilian groups.
Topics: Humans; Female; Stress Disorders, Post-Traumatic; Longitudinal Studies; Surveys and Questionnaires; Risk Factors; Regression Analysis
PubMed: 37119352
DOI: 10.1007/s10900-023-01225-5