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Trauma, Violence & Abuse Oct 2023Revictimization research, to date, has primarily focused on sexual revictimization (i.e., child sexual abuse and adult sexual assault), which has resulted in a lack of... (Review)
Review
Revictimization research, to date, has primarily focused on sexual revictimization (i.e., child sexual abuse and adult sexual assault), which has resulted in a lack of understanding of trauma revictimization more generally. Specifically, it is unclear what factors are placing individuals with a history of child maltreatment (i.e., sexual abuse, physical abuse, and witnessing intimate partner violence [IPV]) at greater risk for subsequent adult victimization (i.e., sexual assault and IPV). Existing theoretical and empirical work on revictimization suggest that multiple risk factors are likely present within this framework (e.g., posttraumatic stress symptoms [PTSS], emotion dysregulation, and risk-taking behaviors). Prior research has suggested that PTSS are often linked with these other risk factors, and it is possible that the development of PTSS following child maltreatment may be related to the development or maintenance of additional factors that increase the likelihood of revictimization. The purpose of this review was to synthesize findings regarding risk factors that place maltreated individuals at greater risk for adult revictimization. Approximately 228 studies were identified following a thorough search of the peer-reviewed literature using multiple databases (PsycINFO, PILOTS, and Google Scholar). Each study was critically analyzed for relevance. The included studies were used in our review of prevalence, specific risk factors that have been identified, and unanswered questions in this literature. PTSS were noted to be particularly important in the revictimization framework, and thus, a novel model of revictimization was also proposed where PTSS are illustrated as being associated with the development and maintenance of other factors within the revictimization framework.
Topics: Adult; Child; Humans; Stress Disorders, Post-Traumatic; Crime Victims; Risk Factors; Child Abuse; Child Abuse, Sexual
PubMed: 35476548
DOI: 10.1177/15248380221093692 -
The Neurologist Nov 2023Delirium is an acute brain dysfunction that has been correlated with adverse mental health outcomes, such as depression and posttraumatic stress disorder (PTSD)....
OBJECTIVES
Delirium is an acute brain dysfunction that has been correlated with adverse mental health outcomes, such as depression and posttraumatic stress disorder (PTSD). However, delirium has not been studied in relation to mental health outcomes after cerebrovascular events. This study aimed to examine the incidence of PTSD after nontraumatic intracerebral hemorrhage (ICH) and identify new predictors of poststroke PTSD symptoms.
METHODS
Clinical data were collected from 205 patients diagnosed with nontraumatic ICH. Demographics and hospital course data were examined. Univariate and multivariable correlational analyses were performed to determine predictors of PTSD symptoms. PTSD symptoms were assessed using PTSD checklist-civilian version (PCL-C) scores.
RESULTS
Diagnostic criteria for a positive PTSD screen (PCL-C score ≥44) were met by 13.7%, 20.2%, and 11.6% of nontraumatic patients with ICH at 3, 6, and 12 months, respectively. On univariate analysis, younger age, female sex, unemployed, and in-hospital delirium were correlated with higher PCL-C scores. In multivariable models, younger age, female sex, unemployed, in-hospital delirium, and a previous anxiety or depression diagnosis were associated with higher PCL-C scores at different follow-up times. Modified Rankin Scale scores were also positively correlated with PCL-C scores at each time point.
CONCLUSIONS
Delirium, previous psychiatric history, younger age, female sex, and unemployment status were found to be associated with a greater degree of posthemorrhagic stroke PTSD symptoms. More significant PTSD symptoms were also correlated with greater functional impairment. A better understanding of patient susceptibility to PTSD symptoms may help providers coordinate earlier interventions.
Topics: Humans; Female; Stress Disorders, Post-Traumatic; Stroke; Delirium
PubMed: 37083500
DOI: 10.1097/NRL.0000000000000495 -
Journal of Traumatic Stress Aug 2023Research has demonstrated a negative association between social support and symptoms of posttraumatic stress disorder (PTSD). This has been interpreted as a protective...
Research has demonstrated a negative association between social support and symptoms of posttraumatic stress disorder (PTSD). This has been interpreted as a protective influence of social support against the development of posttraumatic stress symptoms (PTSS). Research on the opposite association is more limited, but findings suggest that PTSS have a negative impact on social support. There is conflicting evidence that these effects are moderated by gender. Few studies have assessed both associations and gender moderation in a postdisaster context. We examined the longitudinal and bidirectional effects of emotional support and PTSS and whether gender moderates these effects among U.S. survivors of the 2017-2018 season. Participants (N = 1,347) were assessed at four time points over 1 year. Bidirectional effects were assessed using cross-lagged, autoregressive analyses with the combined sample (Model 1) and grouped by gender (Model 2) to assess gender moderation. The results supported small bidirectional negative effects of social support and PTSS on one another from one assessment point (e.g. Wave 1) to the subsequent point (e.g., Wave 2) for all waves, βs = -.07-.15, p < .001-p = .040. Multigroup analyses suggested the effects were not significantly different by gender. Overall, the results suggest that social support and PTSS may mutually diminish one another. Such effects may result in a positive or negative cascade wherein high PTSS may lead to lower social support and, therefore, even higher PTSS and vice versa. These findings support the importance of including social support in interventions to promote PTSS prevention and recovery.
Topics: Male; Humans; Female; Stress Disorders, Post-Traumatic; Disasters; Problem Behavior; Social Support; Survivors
PubMed: 37309234
DOI: 10.1002/jts.22949 -
The American Journal of Hospice &... Aug 2023Post-Traumatic Stress Disorder can be a debilitating comorbidity for a patient on end-of-life care. Combat veterans make up a vast majority of patients diagnosed with...
Post-Traumatic Stress Disorder can be a debilitating comorbidity for a patient on end-of-life care. Combat veterans make up a vast majority of patients diagnosed with Post-Traumatic Stress Disorder and are therefore a vulnerable group requiring a comprehensive approach to their health care management. This paper addresses certain challenges the hospice and palliative care providers may encounter and offers solutions to ensure the patients maintain a high quality of life.
Topics: Humans; Stress Disorders, Post-Traumatic; Quality of Life; Terminal Care; Hospice Care; Palliative Care; Veterans
PubMed: 36283841
DOI: 10.1177/10499091221136287 -
Psychological Trauma : Theory,... Sep 2023Researchers have documented elevated rates of posttraumatic stress disorder (PTSD) in aid workers. Yet, few have investigated the heterogeneity of PTSD presentations in...
OBJECTIVE
Researchers have documented elevated rates of posttraumatic stress disorder (PTSD) in aid workers. Yet, few have investigated the heterogeneity of PTSD presentations in this population. This study examined clinically relevant patterns of PTSD symptomatology in aid workers and examined whether factors such as the degree of trauma exposure (e.g., morally injurious events), social support, and sociodemographic and work characteristics predict symptom profiles.
METHOD
Participants were 243 aid workers who had completed 8.2 assignments on average. They completed measures of trauma exposure, PTSD symptoms, and various types of social support. Latent profile analysis was used to identify PTSD symptom profiles using PCL-5 subscale scores. Next, profiles were compared on 15 potential risk and protective factors.
RESULTS
Five profiles were identified: a no PTSD profile (49.4%), a low subclinical PTSD profile (21.8%), a dysphoric subclinical PTSD profile (5.8%), an intermediate clinical PTSD profile (14.8%), and a severe clinical PTSD profile (8.2%). Profiles differed in terms of witnessed traumatic events, morally injurious exposure, social support adequacy, age, number of assignments, types of assignments, and organizational support.
CONCLUSIONS
This study is the first to identify distinct patterns of PTSD symptomatology in aid workers and to investigate novel psychological risk factors such as potentially morally injurious events. Overall, these findings provide further insight into the risk and protective factors for the psychological well-being of aid workers as well as avenues for improving the psychological assessment and support. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
Topics: Humans; Stress Disorders, Post-Traumatic; Male; Protective Factors; Female; Adult; Social Support; Risk Factors; Middle Aged; Young Adult
PubMed: 37126046
DOI: 10.1037/tra0001512 -
European Journal of Psychotraumatology 2024Posttraumatic stress disorder (PTSD) is considered an independent risk factor for dementia. Despite the (clinical) evidence that PTSD is associated with...
Posttraumatic stress disorder (PTSD) is considered an independent risk factor for dementia. Despite the (clinical) evidence that PTSD is associated with neuropsychiatric symptoms in people with dementia, studies on its prevalence and clinical manifestation are limited, and their quality is affected by the lack of a structured method to diagnose PTSD in this population. The primary aim of the current study is to validate the 'TRAuma and DEmentia' interview as a diagnostic tool for PTSD in people with dementia and to test feasibility of EMDR treatment for people with PTSD and dementia. This prospective multi-centre study is divided into two parts. In study A, 90 participants with dementia will be included to test the criterion validity, inter-rater reliability and feasibility of the 'TRAuma and DEmentia' interview. In study B, 29 participants with dementia and PTSD will receive eye movement desensitisation and reprocessing therapy by a trained psychologist, and 29 participants with dementia and PTSD will be placed on the waiting list control group. This study aims to improve the diagnostic process of PTSD and to assess the effects of eye movement desensitisation and reprocessing treatment in people with dementia living in Dutch care facilities. NL70479.068.20 / METC 20-063 / OSF registration: https://doi.org/10.17605/OSF.IO/AKW4F.
Topics: Humans; Stress Disorders, Post-Traumatic; Prospective Studies; Reproducibility of Results; Eye Movement Desensitization Reprocessing; Dementia; Multicenter Studies as Topic
PubMed: 38488137
DOI: 10.1080/20008066.2024.2320040 -
Psychiatric Services (Washington, D.C.) Oct 2023Preliminary empirical evidence suggests that self-stigma may be a significant problem for those with posttraumatic stress disorder (PTSD). Although research on...
Preliminary empirical evidence suggests that self-stigma may be a significant problem for those with posttraumatic stress disorder (PTSD). Although research on self-stigma for persons with PTSD is limited, some PTSD symptoms, such as negative thoughts about oneself, feelings of shame, and avoidance-particularly of social interactions-may be conceptually related to self-stigma, potentially explaining the co-occurrence and relevance of self-stigma in PTSD. This Open Forum reviews how the social cognitive model may explain the co-occurrence of self-stigma and PTSD, considers how this model may inform treatment approaches for self-stigma in PTSD, and identifies next steps to empirically test the proposed theory.
Topics: Humans; Stress Disorders, Post-Traumatic; Concept Formation; Social Stigma; Shame
PubMed: 36935625
DOI: 10.1176/appi.ps.20220397 -
Expert Review of Neurotherapeutics Feb 2024The focus on perinatal mental health has expanded recently, though there is less research on post-traumatic stress disorder (PTSD). Therefore, a review of the literature... (Review)
Review
INTRODUCTION
The focus on perinatal mental health has expanded recently, though there is less research on post-traumatic stress disorder (PTSD). Therefore, a review of the literature was undertaken and coupled with expert clinical insights to discuss current clinical practice recommendations for PTSD in the perinatal period.
AREAS COVERED
This review covers considerations for the assessment, prevention, and treatment of PTSD during the perinatal period. Within these sections, evidence-based and promising practices are outlined. Extra attention is afforded to treatment, which includes considerations from both psychotherapeutic and psychopharmacological perspectives. This review closes with coverage of three important and related areas of consideration, including bereavement, intimate partner violence, and childhood sexual abuse.
EXPERT OPINION
Psychotherapeutic interventions for PTSD during pregnancy are limited, and no strong recommendations can be supported at this time while evidence points toward the effectiveness of cognitive behavioral therapies and eye movement desensitization therapy as first-line treatments postpartum though research evidence is also limited. Research on psychopharmacological interventions is similarly scarce, though selective serotonin reuptake inhibitors may be beneficial. Clinicians should also be mindful of additional considerations that may be needed for the treatment of PTSD in the context of bereavement, intimate partner violence, and history of sexual violence.
Topics: Pregnancy; Female; Humans; Child; Stress Disorders, Post-Traumatic; Cognitive Behavioral Therapy; Postpartum Period
PubMed: 38196397
DOI: 10.1080/14737175.2024.2303430 -
JAMA Network Open Aug 2023
Topics: Humans; Stress Disorders, Post-Traumatic; Cities; Risk Factors; Surveys and Questionnaires
PubMed: 37585205
DOI: 10.1001/jamanetworkopen.2023.29156 -
Psychological Trauma : Theory,... Sep 2023Moral COVID-19 pandemic. This study aims to explore the relationship between moral injury (MI), posttraumatic stress disorder (PTSD), and suicidal behaviors...
OBJECTIVE
Moral COVID-19 pandemic. This study aims to explore the relationship between moral injury (MI), posttraumatic stress disorder (PTSD), and suicidal behaviors approximately 1 year after the pandemic peaked in mainland China.
METHODS
An online survey was conducted from March 27 to April 26, 2021, across mainland China. A total of 3,465 health professionals completed the Chinese version of the MI Symptoms Scale-Health Professional, Suicidal Behaviors Questionnaire-Revised, and PTSD Checklist for DSM-5 (PCL-5).
RESULTS
The prevalence of PTSD and suicidal behavior among health professionals were 26.9% and 24.2%, respectively. MI is associated with a higher risk of PTSD (OR =3.52, 95% CI [3.01, 4.13]), and a higher risk of suicidal behaviors (OR= 2.13, 95% CI [1.81, 2.50]) under the controlling of sociodemographic variables. And the interaction of PTSD and MI was associated with a significantly increased risk of suicidal behaviors (ORinteraction = 1.61, 95% CI [1.29, 2.02]).
CONCLUSIONS
The MI symptoms are associated with a higher risk of PTSD, and suicidal behaviors among health professionals 1 year after the peak of the COVID-19 pandemic in China. The findings underscore the importance of identifying and treating MI as one way to manage PTSD and suicidal behaviors among health professionals during the postpandemic period. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
Topics: Humans; Stress Disorders, Post-Traumatic; COVID-19; China; Female; Male; Adult; Health Personnel; Middle Aged; Suicidal Ideation; Morals; Young Adult; Prevalence
PubMed: 38885427
DOI: 10.1037/tra0001483