Bushfire and adolescent mental health: A systematic review.

Background: Studies on mental health rates among primary school children are still limited, particularly related to psychological trauma and its relationship to other mental health challenges. Objective: The objective of this study was to 1) examine the prevalence of PTSD, depression, and anxiety symptoms in primary school children before the Covid-19 pandemic; 2) identify the relationship between PTSD, depression and anxiety symptoms; and 3) investigate potential gender differences in PTSD symptoms. Methods: This is the first cross-sectional study examining the rates of trauma exposure, posttraumatic stress disorder (PTSD), depression, and anxiety symptoms in primary school children before the covid-19 pandemic in Malaysia. Two hundred and twenty-one students participated in this study. They were recruited from four primary schools that volunteered to participate in this study. PTSD Checklist for DSM-5 (PCL-5), Child PTSD Symptoms Scale-5 (CPSS-5), The Center for Epidemiologic Studies Depression Scale version (CESD), and the Spence Children's Anxiety Scale (SCAS) were used to survey psychological symptoms. Results: Most of the students, or 54.3% of them, have experienced at least one traumatic event. Of 221 students, 39.4% reported having PTSD symptoms, 38% reported having depressive symptoms, and 19% reported having anxiety symptoms. Female students were more likely to report PTSD symptoms compared to male students. The first regression analysis model indicated that depressive symptoms were the only significant predictors of PTSD. In the second model, religion, family income, anxiety, and PTSD symptoms were significant predictors of depressive symptoms. In the third model, depressive symptoms were the sole significant predictors of anxiety. Conclusion: The study reveals that primary school children experience high levels of trauma, PTSD, depression, and anxiety, especially before the COVID-19 pandemic. During the early phases of the pandemic, these mental health issues have been largely neglected in Malaysia, with limited preventative and therapeutic interventions available. Future research should focus on documenting the prevalence of these issues in relation to the COVID-19 pandemic.

ObjectivesOur objective was to determine if symptoms of depression and posttraumatic stress disorder (PTSD) are associated with peritraumatic dissociation, and if this association is modified by trauma prior to police...

Post-traumatic stress disorder (PTSD) and major depressive disorder (MDD) are associated with functional impairments, yet little is known about their influence on HIV pre-exposure prophylaxis (PrEP) motivation among women survivors of intimate partner violence (IPV). Understanding how PTSD and MDD symptoms influence PrEP motivation is particularly important given survivors of IPV have an increased risk for HIV acquisition. The present study assessed the association between PrEP motivation with latent profiles of PTSD and MDD symptoms among women survivors of IPV. Data were collected from a sample of 285 women from Baltimore, MD, and New Haven, CT. Latent profile analysis (LPA) was performed to identify distinct patterns of depressive and PTSD symptoms among women survivors of IPV. Binary logistic regression was performed to examine the association of profile membership on PrEP motivation. A six-profile solution was determined to best fit the data. Profiles were characterized by: Profile 1, very low depressive and very low PTSD symptoms (28.07%); Profile 2, average depressive symptoms and low (below the mean) PTSD symptoms (21.05%); Profile 3, high depressive symptoms and low (below the mean) PTSD symptoms (9.8%); Profile 4, moderate depressive symptoms and high PTSD symptoms (15.78%); Profile 5, high PTSD avoidance and average depressive symptoms (17.1%); Profile 6, high depressive and high PTSD symptoms (8%). We found that, the odds of being in Stage 3 of the PrEP Motivational Cascade (PrEParation; defined by having access to a medical provider to prescribe PrEP, be willing to take PrEP, and self-identifying as an appropriate candidate for PrEP) compared to Stage 1 of the PrEP Motivational Cascade (Precontemplation; defined by being eligible for PrEP, but not willing to take PrEP and/or not self-identifying as an appropriate candidate for PrEP) were lower for women assigned to the low depressive symptoms and low PTSD symptoms profile (Profile 1 of the LPA) compared to women in the high depressive symptoms and High PTSD symptoms profile (Profile 6 of the LPA, OR = 0.22, 95% CI = 0.06-0.76, p = 0.02). Women assigned to the low PTSD symptoms and average depressive symptoms profile (Profile 2 of the LPA) had lower odds of being in Stage 3 (PrEParation) compared to Stage 1 (Precontemplation) compared to women assigned to the high depressive symptoms and High PTSD symptoms profile (Profile 6 of the LPA, OR = 0.25, 95% CI = 0.07-0.92, p = 0.037). Women survivors of IPV with higher PTSD and MDD symptoms expressed greater motivation to engage in PrEP compared to women survivors with low PTSD and low MDD symptoms. Findings support the CDC's clinical PrEP recommendations to integrate depression screening into PrEP services, but there is a critical need to also include PTSD screening. Further, MDD and PTSD symptoms may present differential barriers to PrEP motivation among women survivors of IPV. Precision care could synchronize trauma-informed practices and mental health treatment to engage survivors in PrEP services.

In this study, we evaluated whether peritraumatic dissociation (PD) was associated with symptoms of depression and posttraumatic stress disorder (PTSD), and whether this association was modified by trauma prior to police work. Symptoms of depression, PTSD, peritraumatic dissociative experience (PDE), and trauma prior to police work were measured using the Center for Epidemiologic Studies Depression scale, PTSD Checklist-Civilian, PDE questionnaire, and the Brief Trauma questionnaire, respectively, in 328 police officers. Separate regression models were used to assess if either symptoms of depression or PTSD were associated with PD stratified by prior trauma. Means were adjusted for race, number of drinks per week, and smoking. PD was associated with symptoms of PTSD and depression (β = 0.65, p < .001 and β = 0.27, p < .001, respectively). PD was positively associated with symptoms of PTSD regardless of prior trauma (β = 0.61, p < .001(without prior trauma), 0.75, p < .001 (with prior trauma). In contrast to PTSD, depression symptoms were significantly associated with PD scores in individuals with prior trauma (β = 0.47, p < .001), but not in individuals without prior trauma (β = 0.13, p = .165). This is a cross-sectional study. Outcomes were obtained via self-report and were not clinically diagnosed. Aspects of both the trauma event as well as the symptoms and severity of PD may have introduced recall bias. These results add to the literature indicating that PD plays a role in symptoms of PTSD and depression and how prior trauma may modify this relationship. (PsycINFO Database Record

Post-trauma patients are at risk of developing symptoms of post-traumatic stress disorder (PTSD) and major depression. The primary goal of this study is to estimate the prevalence of PTSD and depression symptoms in patients who have been hospitalised for the treatment of physical trauma. Additionally, we wanted to compare the prevalence of PTSD or depression symptoms alone versus PTSD associated with depression symptoms, in orthopaedic post-trauma patients. This study had involved orthopaedic post-trauma patients in the orthopaedic ward and clinic of Hospital Tuanku Jaafar (HTJ), Seremban, Malaysia, using an online questionnaire, which consist of English and Malay language. We then determined the prevalence of depression and PTSD symptoms in orthopaedic post-trauma patients and compared this prevalence to the severity of the injuries sustained and any association between PTSD and depression symptoms. Only 12.9% of the participants are likely to have post-traumatic stress disorder (PTSD) symptoms and 43.3% of participants have depression symptoms. There is no significant association between patient demographics and severity of the injuries with the prevalence of post-traumatic stress disorder (PTSD) and depression symptoms. However, of those deemed likely to have PTSD, 93.5% of them had both post-traumatic stress disorder (PTSD) symptoms as well as depressive symptoms. Only a few of the participants are likely to develop post-traumatic stress disorder (PTSD) while almost half of the participants are likely to have developed depression. Physicians caring for trauma patients should screen them for early symptoms of PTSD and depression and treat them accordingly.

Background: Partners of burn survivors may develop posttraumatic stress disorder (PTSD) symptoms in response to the potential life threatening nature of the burn event and the burn survivor’s medical treatment. Objective: This longitudinal study examined the prevalence, course and potential predictors of partners’ PTSD symptoms up to 18 months post-burn. Methods: Participants were 111 partners of adult burn survivors. In a multi-centre study, PTSD symptoms were assessed with the Impact of Event Scale-Revised during the acute phase and subsequently at 3, 6, 12 and 18 months post-burn. Partners’ appraisal of life threat, anger, guilt and level of rumination were assessed as potential predictors of PTSD symptoms in an exploratory piecewise latent growth model. Results: Acute PTSD symptoms in the clinical range were reported by 30% of the partners, which decreased to 4% at 18 months post-burn. Higher acute PTSD symptoms were related to perceived life threat and higher levels of anger, guilt, and rumination. Over time, mean symptom levels decreased, especially in partners with high levels of acute PTSD symptoms, perceived life threat and rumination. From three months onward, PTSD symptoms decreased less in partners of more severely burned survivors. At 18 months post-burn, higher levels of PTSD symptoms were related to higher acute PTSD symptoms and more severe burns. Conclusions: One in three partners reported clinical levels of acute PTSD symptoms, of which the majority recovered over time. Perceived life threat, feelings of anger and guilt, and rumination may indicate the presence of acute PTSD symptoms, whereas more severe burns predict long-term PTSD symptom levels. The results highlight the need to screen for acute PTSD symptoms and offer psychological help to partners to alleviate acute elevated stress levels if indicated.

Project Liberty provided brief crisis counseling to 753,015 residents of New York City and surrounding counties after the attacks on the World Trade Center. Most regained predisaster functioning after counseling. For those who did not, Project Liberty provided enhanced services by specially trained, licensed mental health professionals. Individuals receiving crisis counseling and enhanced services responded to confidential telephone interviews about 18 and 24 months, respectively, after the attacks. Impairment was compared between groups to determine whether enhanced services recipients reported improved functioning and fewer symptoms of depression, posttraumatic stress, and complicated grief. Crisis counseling recipients (N=153) were interviewed once and enhanced services recipients (N=76) were interviewed twice about symptomatology and daily functioning. The samples did not differ in age or gender. Significantly greater proportions of enhanced services recipients reported knowing someone who died as a result of the attacks, having been involved in rescue efforts, or having lost their job because of the attacks. Compared with crisis counseling respondents, enhanced services recipients at their first interview reported significantly more symptoms of depression, grief, and traumatic stress and significantly poorer daily functioning in five life areas. At follow-up, enhanced services respondents reported significant improvement in three of five functioning domains, significantly fewer symptoms of depression and grief, and marginally less traumatic stress. Recipients of enhanced services were more impaired than people who received only crisis counseling. On the basis of reports from service recipients, meaningful improvements in functioning and symptoms may be associated with the receipt of enhanced services.

The Diagnostic and Statistical Manual of Mental Disorders (4th ed., text rev.; DSM-IV-TR; American Psychiatric Association [APA], 2000) emphasizes life threat as the defining feature of psychological trauma. Recent theoretical and empirical work, however, indicates the need to identify and evaluate other key aspects of trauma. Betrayal has been proposed as a pertinent, distinct, and complementary factor that can explain effects of trauma not accounted for by life threat alone. This study examined the relationship between injury, perceived life threat (PLT), and betrayal with posttraumatic stress disorder (PTSD) symptom severity. Trauma-exposed college students (N = 185) completed self-report measures of trauma exposure and PTSD, as well as items regarding life threat, betrayal, and level of medical care received. In hierarchical regressions incorporating injury, PLT, and betrayal, betrayal was associated with all PTSD symptom clusters and PTSD total severity (f(2) = .08), whereas PLT was associated with hyperarousal (f(2) = .05) and PTSD total (f(2) = .03), and injury had no association with PTSD symptoms. In a revised model with trauma type as an additional variable, betrayal was associated with avoidance (f(2) = .03), numbing (f(2) = .04), and PTSD total (f(2) = .03), whereas PLT was associated with reexperiencing (f(2) = .04), hyperarousal (f(2) = .04), and PTSD total (f(2) = .03), and injury was associated with avoidance (f(2) = .03). These findings support the idea that betrayal is a core dimension of psychological trauma that may play an important role in the etiology of PTSD.

Survivors of sexual assault have a high risk for posttraumatic stress disorder (PTSD), but experiencing a sexual assault alone is not sufficient for the development of the disorder. This study examined the impact of other risk factors, including the impact of victim-perpetrator relationship context (i.e. trust, importance, and closeness), perceived life threat, perceived betrayal, posttraumatic cognitions, and trauma-related social support on PTSD and depression symptoms. One hundred twenty-seven female undergraduates who self-identified as “having an uncomfortable, negative, or unwanted sexual experience” completed multiple self-report measures. Victim-perpetrator relationship variables were not associated with PTSD or depressive symptoms. Perceived life threat, perceived betrayal, and posttraumatic cognitions were all related to PTSD symptom severity. However, results from hierarchical multiple regressions indicated that when perceived life threat and posttraumatic cognitions were included in the model, perceived betrayal no longer predicted PTSD symptoms. Implications for understanding the role of posttraumatic cognitions in PTSD and depression symptoms are discussed.

Symptoms of depression and posttraumatic stress disorder (PTSD) were examined for their association with health status in a sample of sexual assault victims. Hypotheses were that symptoms of each disorder would account for unique variance in health status among individuals exposed to traumatic stressors. Fifty-seven sexually assaulted college women were assessed for prior victimization history, assault characteristics, and depressive and PTSD symptoms. When prior history of sexual victimization, assault severity, and physical reactions during the assault were controlled, hierarchical multiple regression models indicated that symptoms of PTSD and depression were significantly associated with global health perceptions and severity of self-reported health symptoms. Only PTSD symptoms were significantly associated with reproductive health symptoms. The results suggest that both symptoms of PTSD and depression account for the relationship between exposure and health impairment among sexual assault victims.

BackgroundBereaved ICU family surrogates are at risk of comorbid prolonged grief disorder (PGD), posttraumatic stress disorder (PTSD), and depression. Knowledge about temporal relationships between PGD, PTSD, and depression is limited by a lack of relevant studies and diverse or inappropriate assessment time frames given the duration criterion for PGD. We aimed to determine the temporal reciprocal relationships between PGD, PTSD, and depressive symptoms among ICU decedents’ family surrogates during their first 2 bereavement years with an assessment time frame reflecting the PGD duration criterion.MethodsThis prospective, longitudinal, observational study examined PGD, PTSD, and depressive symptoms among 303 family surrogates of ICU decedents from two academic hospitals using 11 items of the Prolonged Grief Disorder-13, the Impact of Event Scale—Revised, and the depression subscale of the Hospital Anxiety and Depression Scale, respectively, at 6, 13, 18, and 24 months post-loss. Cross-lagged panel modeling was conducted: autoregressive coefficients indicate variable stability, and cross-lagged coefficients indicate the strength of reciprocal relationships among variables between time points.ResultsSymptoms (autoregressive coefficients) of PGD (0.570–0.673), PTSD (0.375–0.687), and depression (0.591–0.655) were stable over time. Cross-lagged standardized coefficients showed that depressive symptoms measured at 6 months post-loss predicted subsequent symptoms of PGD (0.146) and PTSD (0.208) at 13 months post-loss. PGD symptoms did not predict depressive symptoms. PTSD symptoms predicted subsequent depressive symptoms in the second bereavement year (0.175–0.278). PGD symptoms consistently predicted subsequent PTSD symptoms in the first 2 bereavement years (0.180–0.263), whereas PTSD symptoms predicted subsequent PGD symptoms in the second bereavement year only (0.190–0.214). PGD and PTSD symptoms are bidirectionally related in the second bereavement year.ConclusionsPGD, PTSD, and depressive symptoms can persist for 2 bereavement years. Higher PGD symptoms at 6 months post-loss contributed to the exacerbation of PTSD symptoms over time, whereas long-lasting PTSD symptoms were associated with prolonged depression and PGD symptoms beyond the first bereavement year. Identification and alleviation of depression and PGD symptoms as early as 6 months post-loss enables bereaved surrogates to grieve effectively and avoid the evolution of those symptoms into long-lasting PGD, PTSD, and depression.

The relationship between PTSD and depressive symptoms among children after a natural disaster: A 2-year longitudinal study

Prevalence and Factors Related to Post-traumatic Stress Disorder and Depression Symptoms Among Children and Adolescents Survivors and Orphans of Ebola Virus Disease in Democratic Republic of the Congo Eastern Regions During the COVID-19 Pandemic

People with dissociative symptoms are generally poly-symptomatic and require high levels of healthcare resources. Post-traumatic stress disorder (PTSD) and depressive symptoms are two major disabling comorbid symptoms in people with dissociative symptoms. While the sense of control over symptoms may be associated with PTSD and dissociative symptoms, the interplay among these factors over time remains unexplored. This study examined the predictors of PTSD and depressive symptoms in people with dissociative symptoms. Longitudinal data from 61 participants with dissociative symptoms were analyzed. Participants completed self-report measures of dissociative, depressive, and PTSD symptoms and the sense of control over symptoms two times (T1 & T2) with an interval of over one month. PTSD and depressive symptoms were not transient or time-specific, but they persisted over time in our sample. Hierarchical multiple regression analyses revealed that, after controlling for age, treatment usage and baseline symptom severity, T1 symptom management scores (β = −.264, p = .006) negatively predicted T2 PTSD symptoms, while T1 PTSD symptoms (β = .268, p = .017) positively predicted T2 depressive symptoms. T1 depressive symptoms (β = −.087, p = .339) did not predict T2 PTSD symptoms. The findings highlight the importance of improving symptom management skills and treating comorbid PTSD symptoms when working with people with dissociative symptoms.

Posttraumatic Stress Disorder Symptoms During the First Six Months After Traumatic Brain Injury