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Psychiatry Research Aug 2024Although the high prevalence of intimate partner violence (IPV) in Haiti is well-documented, its association with post-traumatic stress disorder (PTSD) symptoms among...
Although the high prevalence of intimate partner violence (IPV) in Haiti is well-documented, its association with post-traumatic stress disorder (PTSD) symptoms among adolescents and young adults remains unexplored. Using a representative sample of adolescents and young adults from rural and urban areas across the 10 geographical regions of Haiti, this study investigates the association between IPV and PTSD symptoms. It explores the role of social support, emotion regulation, other traumatic events, and sociodemographic factors. The sample consisted of 3,586 participants, of whom 43.21 % (1,538) reported being in a dating relationship in the past year (56.04 % women). Overall, 25.53 % of the participants were categorized as having probable PTSD. Results showed that participants who experienced at least one episode of IPV victimization presented a higher prevalence of PTSD (32.28 %) compared to those who did not have any experience (16.29 %), χ (1) = 44.83, p < .001. The logistic regression model showed that emotional IPV, sexual IPV, traumatic life events, emotional dysregulation, and social support were associated with PTSD symptoms. This study highlights a strong association between IPV and PTSD symptoms, as well as factors that can contribute to the development and implementation of prevention and intervention programs among adolescents and young adults in Haiti.
Topics: Humans; Haiti; Stress Disorders, Post-Traumatic; Female; Adolescent; Male; Intimate Partner Violence; Young Adult; Social Support; Adult; Prevalence; Crime Victims; Emotional Regulation
PubMed: 38838384
DOI: 10.1016/j.psychres.2024.115981 -
Journal of Reproductive and Infant... Nov 2023Addressing psychological trauma after childbirth requires accurate measurement of its prevalence, risk factors, and outcomes using validated instruments that distinguish... (Review)
Review
BACKGROUND
Addressing psychological trauma after childbirth requires accurate measurement of its prevalence, risk factors, and outcomes using validated instruments that distinguish perceptions of traumatic birth, subclinical post-traumatic stress (PTS) symptoms, and symptoms meeting a diagnostic threshold.
OBJECTIVE
The purpose of this study was to review literature on psychological trauma following childbirth and appraise instruments that measure postpartum PTS.
METHODS
In January 2020, the authors searched for and evaluated peer-reviewed studies that quantitatively measured PTS following hospital-based live births in the United States, United Kingdom, Canada, Australia, Norway, Sweden, and Switzerland; 37 articles were selected and evaluated.
RESULTS
Levels of post-traumatic stress disorder were most commonly measured, followed by PTS symptoms. Diagnostic instruments suggested lower PTS prevalence estimates than those screening for or assessing PTS symptoms. Community samples yielded lower prevalence estimates than samples recruited from the internet or settings specifically addressing mental health. Measurement sooner after birth yielded higher estimates.
CONCLUSION
Study design, sample characteristics, instruments, and timing of measurements likely impact postpartum PTS prevalence estimates. Variation in these characteristics make it difficult to draw conclusions on the prevalence of postpartum PTS. Researchers should consider the appraisal of measurement tools presented here and use rigorous study methodology when studying traumatic birth experiences and evaluating interventions.
Topics: Pregnancy; Female; Humans; Parturition; Stress Disorders, Post-Traumatic; Delivery, Obstetric; Postpartum Period; Research Design
PubMed: 35083966
DOI: 10.1080/02646838.2022.2030052 -
Neuropsychologia Sep 2023The ability to make accurate predictions about what is going to happen in the near future is critical for comprehension of everyday activity. However, predictive...
The ability to make accurate predictions about what is going to happen in the near future is critical for comprehension of everyday activity. However, predictive processing may be disrupted in Posttraumatic Stress Disorder (PTSD). Hypervigilance may lead people with PTSD to make inaccurate predictions about the likelihood of future danger. This disruption in predictive processing may occur not only in response to threatening stimuli, but also during processing of neutral stimuli. Therefore, the current study investigated whether PTSD was associated with difficulty making predictions about near-future neutral activity. Sixty-three participants with PTSD and 63 trauma controls completed two tasks, one testing explicit prediction and the other testing implicit prediction. Higher PTSD severity was associated with greater difficulty with predictive processing on both of these tasks. These results suggest that effective treatments to improve functional outcomes for people with PTSD may work, in part, by improving predictive processing.
Topics: Humans; Stress Disorders, Post-Traumatic
PubMed: 37437653
DOI: 10.1016/j.neuropsychologia.2023.108636 -
Psychological Trauma : Theory,... Feb 2024Trauma-related fear (e.g., reexperiencing), impaired reward (e.g., anhedonia), and interpersonal (e.g., detachment) processes may be functionally intertwined, giving...
OBJECTIVE
Trauma-related fear (e.g., reexperiencing), impaired reward (e.g., anhedonia), and interpersonal (e.g., detachment) processes may be functionally intertwined, giving rise to chronic psychopathology after a trauma. Network analyses can help pinpoint symptom drivers and treatment targets, but studies examining posttraumatic stress disorder (PTSD) treatment-seeking individuals are lacking.
METHOD
Treatment-seeking adults with primary PTSD ( = 350) completed interview and self-report measures of PTSD severity (PSS-I; PSS-SR). Self-report and interview-based networks were estimated and compared.
RESULTS
Both networks suggested distinct but interconnected communities of reexperiencing and dysphoric symptoms (e.g., interpersonal detachment, numbing). Centrality profiles were strongly associated across networks ( = .71), with cued reexperiencing and interpersonal detachment showing strong centrality. Self-reported symptoms were more interconnected, suggesting lower specificity.
CONCLUSIONS
For those seeking treatment, interrelated fear and interpersonal processes may drive functional impairment in PTSD, and interview-based networks may help better delineate influential symptoms. Therapeutically, targeting cued reexperiencing and interpersonal detachment may facilitate broader symptom decreases. (PsycInfo Database Record (c) 2024 APA, all rights reserved).
Topics: Adult; Humans; Stress Disorders, Post-Traumatic; Self Report; Cues; Fear; Psychopathology
PubMed: 34672659
DOI: 10.1037/tra0001151 -
Brain and Behavior Dec 2023Posttraumatic stress disorder (PTSD) is a complex and heterogeneous mental health condition that can develop after exposure to a traumatic event. Clinical trials have... (Review)
Review
BACKGROUND
Posttraumatic stress disorder (PTSD) is a complex and heterogeneous mental health condition that can develop after exposure to a traumatic event. Clinical trials have used alternative pharmacological agents to treat PTSD, but their associated neural correlates remain unclear. The present systematic review aims to summarize the changes in brain function associated with the use of these alternative pharmacological agents in PTSD.
METHODS
Clinical trials using functional magnetic resonance imaging, either at rest or during the performance of tasks, were included if they compared the effects of alternative pharmacological agents between PTSD patients and either trauma-exposed controls or never-exposed healthy controls.
RESULTS
Sixteen studies were included, of which 11 used intranasal oxytocin, 2 used hydrocortisone, and 3 used delta-9-tetrahydrocannabinol (THC). Oxytocin administration was associated with the normalization of functional connectivity between the ventromedial prefrontal cortex and amygdala as well as enhanced the function of brain regions specifically involved in emotion processing (e.g., amygdala), working memory (e.g., dorsolateral prefrontal cortex), and reward (e.g., putamen). Hydrocortisone did not influence brain function at rest or during the performance of an autobiographical memory task, whereas THC was associated with the reduction of the amygdala and increased medial prefrontal cortex activation.
CONCLUSIONS
This systematic review identified preliminary evidence for normalizing brain function after the use of alternative pharmacological agents. Importantly, sex-specific differences were noted, in particular when using oxytocin, that will require further investigation.
Topics: Female; Humans; Male; Brain; Emotions; Hydrocortisone; Magnetic Resonance Imaging; Oxytocin; Stress Disorders, Post-Traumatic; Clinical Trials as Topic
PubMed: 37864378
DOI: 10.1002/brb3.3292 -
Archives of Suicide Research : Official... 2024Trauma and stressor-related behavioral health conditions are prevalent in military populations and have become a major public health concern in recent years. Individuals...
OBJECTIVE
Trauma and stressor-related behavioral health conditions are prevalent in military populations and have become a major public health concern in recent years. Individuals who commonly report suicidal ideation often have comorbid mental health diagnoses (i.e., posttraumatic stress disorder; PTSD). However, the mechanisms associated with stress, suicidal ideation, and PTSD are unclear.
METHOD
The present study examined the moderating role of dysfunctional and recovery cognitions between (i) PTSD and suicidal ideation, and (ii) stress and suicidal ideation in two distinct samples. Sample 1 was composed of civilians and military personnel ( = 322). Sample 2 was composed of ( = 377) student service members and veterans (SSM/Vs).
RESULTS
In Study 1, we found that low recovery cognitions at higher and moderate levels of PTSD symptoms were significantly associated with increased suicidal ideation. High dysfunctional cognitions were significantly associated with suicidal ideation at higher levels of PTSD symptoms. In Study 2, we found no differences in any level of recovery cognitions at low and moderate stress levels with suicidal ideation. Higher levels of stress were associated with high dysfunctional cognitions and suicidal ideation.
CONCLUSION
Promoting higher levels of recovery cognitions and reducing dysfunctional cognitions are important in addressing stress, suicidal ideation, and comorbid conditions such as PTSD. Future research should focus on examining the clinical utility of the Dispositional Recovery and Dysfunction Inventory (DRDI) in other populations (i.e., firefighters and paramedics). This could contribute to efforts of suicide prevention and the promotion of the well-being of individuals experiencing suicidal ideation.
Topics: Humans; Suicidal Ideation; Stress Disorders, Post-Traumatic; Male; Female; Adult; Military Personnel; Veterans; Stress, Psychological; Young Adult; Cognition; Middle Aged
PubMed: 37073774
DOI: 10.1080/13811118.2023.2199798 -
Journal of the American Academy of... Aug 2023To determine the incidence of posttraumatic stress disorder (PTSD) symptoms and risk factors for their development in children and adolescents undergoing orthopaedic...
OBJECTIVE
To determine the incidence of posttraumatic stress disorder (PTSD) symptoms and risk factors for their development in children and adolescents undergoing orthopaedic surgery for trauma.
DESIGN
Prospective cohort study.
SETTING
Level-1 trauma center.
PATIENTS
Children (8 to 18), undergoing surgery for orthopaedic trauma.
INTERVENTION
Upper and lower extremity surgery for orthopaedic trauma.
MAIN OUTCOME MEASUREMENTS
PTSD symptoms at postoperative follow-up as determined by the Child PTSD Symptom Scale (CPSS).
RESULTS
A total of 176 children with an average age at surgery of 13 years (8 to 18.8 years) participated in the study. Twenty-six subjects had high levels of PTSD symptoms (15%; 95% CI = 10.0 to 21.1%). Univariable and multivariable analyses determined that female sex (OR 2.63, 95% CI = 1.06 to 6.67, P = 0.04), older age at surgery (OR 1.25, 95% CI = 1.04 to 1.51, P = 0.02), and undergoing a previous surgery (OR 2.86, 95% CI = 1.06 to 7.73, P = 0.04) were all associated with increased PTSD risk.
CONCLUSIONS
Children and adolescents experience a high level of PTSD symptoms (15%) after surgery for orthopaedic trauma. Clinicians should be aware of PTSD symptoms in children and adolescents after surgery for orthopaedic injuries and use comprehensive screening to facilitate timely intervention and treatment.
LEVEL OF EVIDENCE
II.
Topics: Adolescent; Humans; Child; Female; Stress Disorders, Post-Traumatic; Prospective Studies; Incidence; Risk Factors; Orthopedics
PubMed: 37579777
DOI: 10.5435/JAAOSGlobal-D-22-00245 -
Journal of Clinical Psychology Sep 2023Firefighters represent an understudied population with high rates of chronic exposure to stress and potentially traumatic events. Thus, there is a need to identify...
OBJECTIVE
Firefighters represent an understudied population with high rates of chronic exposure to stress and potentially traumatic events. Thus, there is a need to identify modifiable resilience factors to address posttraumatic stress disorder (PTSD) symptoms (PTSD) and chronic pain in firefighters to inform prevention and intervention efforts.
METHODS
The current sample included 155 firefighters (93.5% male; M = 42.2, SD = 9.8) recruited online from career, volunteer, and combination (i.e., volunteer and career) departments in a large metropolitan area in the southern United States.
RESULTS
Structural equation modeling (SEM) was used to investigate the associations between/among resilience and hope on PTSD symptoms, chronic pain, well-being, and posttraumatic growth (PTG). Resilience had a stronger, negative relationship with PTSD and chronic pain compared to hope, while hope had a stronger, positive relationship with PTG and well-being compared to resilience. Hope and resilience combined predicted 10%-33% of the variance in the outcomes.
CONCLUSION
The current findings may provide evidence to promote interventions that increase resilience and hope in firefighters.
Topics: Humans; Male; United States; Adult; Female; Firefighters; Chronic Pain; Posttraumatic Growth, Psychological; Stress Disorders, Post-Traumatic
PubMed: 37212250
DOI: 10.1002/jclp.23534 -
Sleep Medicine Oct 2023Strong evidence supports a bidirectional association between sleep disturbances and posttraumatic stress disorder (PTSD). Affect - temporary internal states experienced... (Review)
Review
Strong evidence supports a bidirectional association between sleep disturbances and posttraumatic stress disorder (PTSD). Affect - temporary internal states experienced as feeling good or bad, energized or enervated - may play a central role in explaining this link. The current systematic review summarizes the literature on associations between sleep, PTSD, and affect among trauma-exposed adults. We systematically searched five electronic databases (PubMed, PsycInfo, PTSDpubs, Web of Science, CINAHL) using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 guidelines. Of 2656 screened articles, 6 studies met inclusion criteria. Four findings emerged: (1) greater insomnia symptom severity predicted greater PTSD symptom severity above the influence of negative affect, (2) negative affect mediated the effect of sleep quality on next-day PTSD symptom severity, (3) positive affect mediated the effect of PTSD symptom severity on insomnia symptom severity and sleep disturbances, and (4) greater negative affect (specifically, greater anger) was associated with greater severity of PTSD and sleep disturbances. Findings highlight areas for future research, such as the need to investigate more dimensions, timescales, and methods of studies simultaneously assessing affect, sleep, and PTSD, as well as the need for more longitudinal and experimental work to determine causality across these constructs.
Topics: Adult; Humans; Stress Disorders, Post-Traumatic; Sleep Initiation and Maintenance Disorders; Sleep Wake Disorders; Emotions; Sleep
PubMed: 37689045
DOI: 10.1016/j.sleep.2023.08.025 -
BMC Psychology Oct 2023The 5th revision of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) construes PTSD symptoms into 4 clusters (intrusion, avoidance, negative alterations...
BACKGROUND
The 5th revision of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) construes PTSD symptoms into 4 clusters (intrusion, avoidance, negative alterations in cognitions and mood, alterations in arousal and reactivity; Model 1). However, recent literature has shown that this symptom structure does not best represent PTSD. Unfortunately, the findings of studies investigating the proposed alternative models are from consensus. Adding to the complexity of the issue of symptom-grouping models is the identification of specific and non-specific symptoms of PTSD. The present study aims to address these gaps by identifying the best-fitting PTSD model and subsequently examining what symptoms are considered specific and non-specific to PTSD in adolescent-survivors of armed political conflict and violence.
METHODS
The study utilized a sample of 641 adolescent victim survivors. We conducted CFA analyses and compared nested models through the scaled χ difference test, while comparison of non-nested models was done using the Bayesian information criterion (BIC). The best-fitted model was used in the consequent analysis, where we statistically controlled for the effect of non-specific psychological distress on PTSD by comparing the factor loadings and factor correlations before and after accounting for distress using the Aroian z-test.
RESULTS
The results provide support for the 7-factor hybrid model of PTSD over other proposed models for the current sample. Moreover, the data reveal that only 7 items could be construed as core symptoms, while the rest of the symptoms can be considered non-PTSD specific.
CONCLUSIONS
Overall, the findings provide support for the validity of the hybrid PTSD model among political conflict-exposed adolescents. The results also show that the DSM-5 PTSD has both specific and non-specific features in the present sample of conflict-exposed adolescents. This has potential implications for theory, practice, and treatment of the disorder.
Topics: Humans; Adolescent; Stress Disorders, Post-Traumatic; Bayes Theorem; Factor Analysis, Statistical; Affect; Cognition
PubMed: 37875987
DOI: 10.1186/s40359-023-01389-8