Acute Stress Disorder Symptoms Research Articles

Initial psychological assistance for military servants with symptoms of acute stress disorder

Purpose The purpose of this study is to determine the psychological features of providing initial psychotherapeutic assistance to victims, in particular to military servants. Design/methodology/approach Theoretical analysis of scientific works; observation of servicemen in hospital conditions; conversations with servicemen and doctors; and interviews with foreign colleagues. Findings As a result of theoretical and empirical research, it was found that initial psychological assistance is more effective if it is provided in a timely and comprehensive manner in cooperation with medical assistance, if the recommended exercises are performed systematically by the victim and if a certain algorithm for providing initial psychotherapeutic assistance is used. Originality/value The authors present their own algorithm for providing initial psychological assistance to military servants: psychophysiological stabilization; adjustment of emotional balance; restoration of cognitive processes and acquisition of constructive coping strategies; and formation of life meanings that provide an opportunity to survive the crisis period of life. In this paper, the authors also note the importance of providing psychological first aid to victims of extreme situations in a timely manner, which helps reduce the intensity of symptoms of acute stress disorder and reduces the likelihood of post-traumatic stress disorder.

Acute Stress Disorder among 2022 Ukrainian war refugees: a cross-sectional study.

Fleeing from war can be terrifying and result in Acute Stress Disorder (ASD), a mental health condition that can occur in the first month after a traumatic event. The study aimed to identify the prevalence of ASD among Ukrainian refugees and identify its risk factors to create a profile of the most vulnerable refugees. This cross-sectional study of 637 Ukrainian war-displaced persons and refugees in 2022 used the Acute Stress Disorder Scale. The prevalence of ASD among participants was high (93.5%). Several factors increasing the risk of developing ASD in the sample were identified, e.g., witnessing Russian attacks (OR 2.92, 95% CI 1.26-6.78), insufficient financial resources (OR 3.56, 95% CI 1.61-7.91), and feeling of loneliness in the host country (OR 3.07, 95% CI 1.58-8.69). Pre-existing depression and the death of a close person, among others, were found to significantly (p < 0.05) exacerbate the ASD symptoms. At the same time, neither age, the distance traveled, time spent on fleeing the country, nor the type of companionship during refuge (escaping alone, with children, pets or the older adults) correlate with the severity of symptoms. The study shows extreme levels of trauma among Ukrainian war refugees and displaced persons. Knowledge regarding ASD vulnerabilities in the present conflict may facilitate prompt and adequate psychological help. Since ASD can be an antecedent of PTSD and several autoimmune disorders, these results may also serve as a predictor of future challenges for Ukrainian society.

Metaphorical language and psychopathological symptoms: a case study of trauma victims’ metaphor use

BackgroundWhile clinical diagnosis of mental health issues focuses on factual details represented by literal language (e.g., the onset and process of the triggering event and duration of symptom), the relationship between metaphorical language and psychopathological experiences remains an intriguing question. Focusing on psychological trauma triggered by the 2019–2020 Hong Kong social unrest, this study explored the correlations between trauma victims’ quantitative metaphor usage patterns and their experience of specific Acute Stress Disorder (ASD) symptoms.MethodsForty-six individuals with trauma exposure within 28 days were recruited through convenience sampling. Each completed a 20– to 30-minute semi-structured interview and filled out the Chinese version of the Stanford Acute Stress Reaction Questionnaire (SASRQ; 1). Metaphors in the interviews were identified using the discourse dynamic approach (2), and clinically interesting categories related to trauma and emotion expression, as revealed by previous literature, were sorted out. Standardized frequencies of the categories were correlated with participants’ SASRQ scores of five major ASD symptoms, and the correlational patterns were interpreted from a discourse analytic perspective.ResultsThe study reveals how metaphor usage patterns can reflect the speakers’ differentiated experiences of psychopathological symptoms. Compared with individuals who experienced less trauma, those more disturbed by the re-experiencing symptom were more inclined to use emotion-related metaphors and to metaphorize about the self and the self-society relationship. Individuals who experienced more severe anxiety and hyperarousal showed a heightened awareness of self-related issues and diminished attention to others. Those who suffered from more severe impairment in functioning produced more metaphors in the negative valence. Dissociation and avoidance, which were less experientially salient and intense than the others, were not significantly correlated with metaphor usage patterns.ConclusionThis study establishes symptom-level metaphor usage patterns as a previously overlooked but interesting avenue in trauma evaluation, treatment, and research. While the study is confined to a single context, it nevertheless reveals the potential for metaphor research findings to be incorporated as useful materials in psychology education and therapist training.

Prospective Bidirectional Relationship Between Sleep Duration and Posttraumatic Stress Disorder Symptoms After Suspected Acute Coronary Syndrome.

Sleep disturbance is a "hallmark" symptom of posttraumatic stress disorder (PTSD). Poor sleep (including short sleep) after combat-related trauma can also predict subsequent PTSD. Less is known about the association between sleep duration and PTSD symptoms when PTSD is induced by acute coronary syndrome (ACS). We examined the bidirectional relationship between sleep duration and PTSD symptoms over the year after hospital evaluation for ACS. Participants were enrolled in this observational study after emergency department evaluation for ACS. Sleep duration ("During the past month, how many hours of actual sleep did you get at night?") and cardiac event or hospitalization-induced PTSD symptoms (PTSD Checklist) were assessed at 1, 6, and 12 months after hospital discharge. Cross-lagged path analysis was used to model the effects of sleep duration and PTSD symptoms on each other. Covariates included age, sex, race/ethnicity, cardiac severity, baseline depression symptoms, and early acute stress disorder symptoms. The sample included 1145 participants; 16% screened positive for probable PTSD (PTSD Checklist score ≥33). Mean sleep duration across time points was 6.1 hours. Higher PTSD symptoms predicted shorter sleep duration at the next time point (i.e., 1-6 and 6-12 months; B = -0.14 hours/10-point difference, SE = 0.03, p < .001). Shorter sleep duration was associated with higher PTSD symptoms at the next time point (B = -0.25 points/hour, SE = 0.12, p = .04). Short sleep duration and PTSD symptoms are mutually reinforcing across the first year after ACS evaluation. Findings suggest that sleep, PTSD symptoms, and their relationship should be considered in the post-ACS period.

Trajectories and determinants of acute stress disorder during the COVID-19 centralized quarantine: A latent class growth analysis.

COVID-19 centralized quarantine may cause acute stress disorder (ASD). However, it is unknown how individuals present heterogeneous ASD trajectories during the COVID-19 centralized quarantine and what factors contribute to these patterns. This study aimed to identify the ASD trajectories and their determinants during the centralized quarantine period, and the mediating effects of resilience on these associations. A longitudinal survey with three waves was conducted in a randomly selected quarantine hotel in Shenzhen, China from October to November 2020. A total of 273 participants completed online measures assessing ASD symptoms, Eysenck's personality constructs of extraversion (E), neuroticism (N), psychoticism (P), and resilience on Day 1, and reported ASD symptoms on Days 7 and 14 during their 14-day centralized quarantine periods. Latent class growth analysis identified three trajectories: constantly high symptoms (CHS, 4.76%), decreasing symptoms (DS, 11.72%), and constantly low symptoms (CLS, 83.52%). The CHS and DS subgroups both reported lower E and higher N scores, but not P, compared with the CLS subgroup. Resilience mediated the effects of three personality constructs on ASD trajectories, except for the association between N and DS membership. Our study highlights the heterogeneity in stress responses to the COVID-19 centralized quarantine. The high-risk subgroup with persistent ASD symptoms was characterized by lower E and higher N. The resilience process accounted for the effects of personality in shaping distinct ASD trajectories. Our findings have implications to detect the populations vulnerable to ASD and provide insights for developing timely resilience enhancement intervention programs.

(150) Intravenous Ketamine Exacerbating Symptoms of Acute Stress Disorder: A Case Report and Systematic Review of Existing Literature

(150) Intravenous Ketamine Exacerbating Symptoms of Acute Stress Disorder: A Case Report and Systematic Review of Existing Literature

Development and psychometric validation of the Pandemic-Related Traumatic Stress Scale for children and adults.

To assess the public health impact of the COVID-19 pandemic on mental health, investigators from the National Institutes of Health Environmental influences on Child Health Outcomes (ECHO) research program developed the Pandemic-Related Traumatic Stress Scale (PTSS). Based on the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5) acute stress disorder symptom criteria, the PTSS is designed for adolescent (13-21 years) and adult self-report and caregiver-report on 3-12-year-olds. To evaluate psychometric properties, we used PTSS data collected between April 2020 and August 2021 from non-pregnant adult caregivers (n = 11,483), pregnant/postpartum individuals (n = 1,656), adolescents (n = 1,795), and caregivers reporting on 3-12-year-olds (n = 2,896). We used Mokken scale analysis to examine unidimensionality and reliability, Pearson correlations to evaluate relationships with other relevant variables, and analyses of variance to identify regional, age, and sex differences. Mokken analysis resulted in a moderately strong, unidimensional scale that retained nine of the original 10 items. We detected small to moderate positive associations with depression, anxiety, and general stress, and negative associations with life satisfaction. Adult caregivers had the highest PTSS scores, followed by adolescents, pregnant/postpartum individuals, and children. Caregivers of younger children, females, and older youth had higher PTSS scores compared to caregivers of older children, males, and younger youth, respectively. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Consensus on the pharmacological treatment of acute stress disorder in Chinese pilots: a Delphi study

BackgroundAppropriate medication is very important for pilots with acute stress disorder. Improper medication can not only affect the physical and mental health of the pilots but can also endanger flight safety. Hence, we aimed to quickly and effectively relieve symptoms and restore cognitive function by forming a consensus of Chinese experts on the pharmacological treatment of acute stress disorder in pilots using the Delphi method.MethodsRelevant literature was searched to enumerate the current status of pharmacological treatment of acute stress disorder in pilots, followed by two rounds of expert consultation and discussion according to the listed status of the survey using the Delphi method. A descriptive statistical method was used to analyze the basic information, authority coefficients, concentration of opinions, and survey items of the experts to develop a consensus on the pharmacological treatment of acute stress disorder in pilots.ResultsA total of 16 experts in psychiatry, pharmacology, and aerospace medicine from different provinces and cities across China were invited for consultation. The recovery rate of the two rounds of consultation was 100%, and the expert authority coefficients were 0.897 and 0.906, respectively. Kendall’s coefficient of concordance of indicators at all levels was 0.564–0.594 (p < 0.01). Based on the number of votes received, alprazolam tablets (16), eszopiclone tablets (15), and lorazepam tablets (14) were recommended for the treatment of excitatory psychomotor symptoms of acute stress disorder; paroxetine tablets (15) and sertraline tablets (15) were available for psychomotor depressive symptoms; olanzapine tablets (15), olanzapine orally disintegrating tablets (14), and quetiapine fumarate tablets (14) were selected for psychotic symptoms.ConclusionsThis study formed a consensus on rapid and effective pharmacological treatment for different symptoms of acute stress disorder pilots, which provides a reference for clinical treatment.

Obstetric outcome and emotional reactions to childbirth in women with dyspareunia: A cross-sectional study

ObjectiveTo assess obstetrical outcomes, perceptions of childbirth experience and emotional adjustment, in women with dyspareunia. Study designIn this cross-sectional study, 440 women were recruited within 48 h postpartum in the maternity ward of a large medical center, during the period of April 2018- August 2020. Self-report questionnaires were administered which addressed demographic and reproductive background, dyspareunia, perceptions of control during labor (Labor Agentry Scale), perceived professional support (Intrapartum Care Scale), and maternal adjustment, implicated in perinatal dissociation (Peritraumatic Dissociative Experiences Questionnaire), acute stress disorder (ASD) symptoms (Stanford Acute Stress Reaction Questionnaire), bonding (Mother-to-Infant Bonding Scale), anticipated maternal self-efficacy (Maternal Self-Efficacy Scale) and well-being (Positive and Negative Affect Schedule, Edinburgh Postnatal Depression Scale). Obstetrical information was retrieved from clinical files and included pregnancy complications, week and mode of delivery, nature of labor onset, analgesia during delivery, birthweight, perineal tears. ResultsThe dyspareunia group included 71 women (18.3%) and the comparison group 317 (81.7%). Demographic data were similar among groups. No difference was observed in nature of labor onset, type of analgesia, route of delivery, perineal tears. More participants with dyspareunia had premature delivery versus comparisons (14.1% vs 5.6%, p = 0.02). Women with dyspareunia reported lower levels of control (p = 0.01) and perceived support during childbirth (p < 0.001), higher levels of perinatal dissociation (p < 0.001) ASD symptoms (p < 0.001), depression (p = 0.02), negative affect (p < 0.001), and reported lower levels of maternal bonding (p < 0.001) and anticipated maternal self-efficacy (p = 0.01). ConclusionDyspareunia was associated with more premature deliveries, parameters of emotional distress during childbirth and poorer maternal adjustment following childbirth. Perinatal caregivers should be cognizant of such cognitive and emotional reactions in women with dyspareunia, so as to assess for a history of dyspareunia in pregnant women and provide adequate support during pregnancy and delivery.

Factors Associated with Acute Stress Among Undergraduate and Graduate Students after the First Month of the Covid-19 Pandemic: Anxiety Sensitivity, Fear of Covid-19, Sex

As with any life-threatening event, the Covid-19 outbreak causes people to have emotional reactions such as fear and anxiety. Understanding people’s emotional responses to the pandemic is important to understand mental health results. This study investigated the relationships between the levels of acute stress disorder symptoms, anxiety sensitivity, and fear of coronavirus. Data for this aim was collected from university students between the ages of 18 and 55 through an online research form. Data was collected between 23 April 2020 and 29 May 2020. Analysis of 739 participants showed that 67.9% of the participants had symptoms of acute stress ranging from moderate to extreme. It was also observed that anxiety sensitivity, fear of coronavirus, and sex explained 31.0% of the variance in acute stress symptom levels. Also, it was observed that the fear of coronavirus was higher in women than in men. The results point out that support systems that aid psychological well-being such as accessible online psychological help, and online social support groups have great importance during and after the pandemic. It has been thought that it may be beneficial to develop intervention programs targeting anxiety sensitivity to prevent trauma symptoms.

Attributional negativity bias and acute stress disorder symptoms mediate the association between trauma history and future posttraumatic stress disorder.

Individuals who have experienced more trauma throughout their life have a heightened risk of developing posttraumatic stress disorder (PTSD) following injury. Although trauma history cannot be retroactively modified, identifying the mechanism(s) by which preinjury life events influence future PTSD symptoms may help clinicians mitigate the detrimental effects of past adversity. The current study proposed attributional negativity bias, the tendency to perceive stimuli/events as negative, as a potential intermediary in PTSD development. We hypothesized an association between trauma history and PTSD symptom severity following a new index trauma via heightened negativity bias and acute stress disorder (ASD) symptoms. Recent trauma survivors (N =189, 55.5% women, 58.7% African American/Black) completed assessments of ASD, negativity bias, and lifetime trauma 2-weeks postinjury; PTSD symptoms were assessed 6 months later. A parallel mediation model was tested with bootstrapping (10,000 resamples). Both negativity bias, Path b1 : β = -.24, t(187) = -2.88, p = .004, and ASD symptoms, Path b2 : β = .30, t(187) = 3.71, p < .001, fully mediated the association between trauma history and 6-month PTSD symptoms, full model: F(6, 182) = 10.95, p < .001, R 2 = .27; Path c': β = .04, t(187) = 0.54, p = .587. These results suggest that negativity bias may reflect an individual cognitive difference that can be further activated by acute trauma. Moreover, negativity bias may be an important, modifiable treatment target, and interventions addressing both acute symptoms and negativity bias in the early posttrauma period may weaken the link between trauma history and new-onset PTSD.

COVID-19 pandemic and post-traumatic stress among Moroccan caregivers

The COVID-19 pandemic is an unprecedented challenge to society. Mental health support for health care workers is a critical component of the public health response. There is an urgent need to provide mental health support for front-line caregivers at risk for mental injury and post-traumatic stress disorder. We describe the literature base for a multilevel model of care and the practical steps for its implementation. The goal is to know the frequency of these disorders and the appropriate model of care. We reviewed articles found on PubMed through March 20, 2021, using the following keywords : Moral injury : a particular type of trauma characterized by guilt, existential crisis, and loss of confidence that can develop as a result of a perceived moral violation ; Acute stress : a characteristic set of symptoms that may develop in response to exposure to a traumatic event(s). It usually involves an anxiety response that includes some form of reliving or reactivity to the traumatic event ; Post-traumatic stress disorder : a characteristic set of symptoms that develops following exposure to a traumatic event(s). A manual search of Google Scholar was performed to identify additional relevant studies. We included articles that met the following inclusion criteria : studies investigating possible risk and/or resilience factors for symptoms of moral injury, acute stress, post-traumatic stress disorder, and prevention steps among caregivers facing the COVID-19 pandemic. The initial search generated 122 articles and a total of 36 articles meeting our inclusion criteria. Symptoms of acute stress disorder, post-traumatic stress disorder in resuscitation providers and the risk of PTSD for front-line staff was approximately 10%.

Analysis of clinical medication scheme and nursing measures of acute stress disorder complicated with delirium under the COVID-19

BackgroundCOVID-19 is highly contagious, which has a significant impact on people’s physical health and mental health. Under the current COVID-19, some people have negative emotions, such as anger and fear, which have triggered psychological stress, resulting in acute stress disorder of different degrees. Therefore, the study put forward a targeted clinical medication scheme. It applies corresponding nursing measures to explore the role of the targeted medication scheme in improving the mental health and the life quality of patients.Subjects and MethodsAmong the patients with acute stress disorder admitted to our hospital from June 2020 to July 2021, 80 patients with delirium caused by the COVID-19 were selected as research objects according to the medical records and disease analysis. Before using the new clinical medication scheme and nursing measures for treatment, the patients’ delirium and stress disorder were evaluated by Stanford Acute Stress Response Questionnaire (SASRQ) and 3-min Confusion Assessment Scale (3D-CAM). Then the new clinical medication scheme and nursing measures was applied for four weeks, including specific medication for acute stress disorder and delirium, and evaluate the disease status again with the two selected scales.ResultsTable 1 shows the results of SASRQ score and 3D-CAM score of 80 selected patients before and after treatment. The results showed that before treatment, both the SASRQ score and the 3D-CAM score showed that the patient had different degrees of delirium and acute stress disorder. After treatment, both the 3D-CAM score and the SASRQ score of the patient decreased significantly, and the symptoms of acute stress disorder complicated with delirium were significantly improved, with a statistically significant difference (P &lt; 0.05).Table 1.Results of SASRQ score and 3D-CAM score of 80 patients before and after treatmentTreatment stagenSASRQ score3D-CAM scoreBefore treatment8045.4±2.346.5±2.1After treatment8038.6±1.639.2±2.5t-21.7120.00P-0.000.00ConclusionsUnder the COVID-19, some people suffer from acute stress disorder and delirium. Therefore, the study put forward a specific clinical medication scheme and nursing measures for these patients, and assessed the acute stress disorder and delirium status before and after treatment through SASRQ and 3D-CAM scales. The results verified the effectiveness of the medication scheme, which had certain clinical application value.

Gebelik Kaybı Sonrası Akut Stres Bozukluğunun Değerlendirilmesi

Aim: Our study aimed to assess and prevent acute stress disorder in women with pregnancy loss.&#x0D; &#x0D; Materials And Methods: Pregnant women presenting to the Department of Obstetrics and Gynecology at level 2 centers between March 2019 and March 2021 were included in the study. Women with pregnancy loss of fewer than 21 weeks were assigned to the "pregnancy loss group" and women with healthy pregnancies were assigned to the "control group." Participants were asked to complete a questionnaire. The questionnaire included questions about pregnancy history, sociodemographic data, and medical history. After the questionnaire, patients were asked to complete the post-traumatic stress disorder (PTSD) scale. Of the patients who participated in the study, 91 (35%) were in the pregnancy loss group and 156 (65%) were in the control group. Statistically, p &lt; 0.05 was considered significant.&#x0D; &#x0D; Results: The mean age of the patients with pregnancy loss was 27.52±5.60 years, whereas the pregnant women in the control group were 26.43±5.44 years old. The mean age of the two groups was similar (p=0.656). The PTSD score of the participants was 33.10±9.3 (min=15, max=49). The mean PTSD score of the cases who suffered pregnancy loss was 36.23±9.49 and 31.12±7.34 in the control group. The PTSD score of the group with pregnancy loss was significantly higher than that of the control group (p=0.003).&#x0D; &#x0D; Conclusion: In our study, symptoms of acute stress disorder were found to be more common in women who experienced pregnancy loss. Couples who have suffered pregnancy loss should receive social and psychological support. Psychological support and counseling are very important for the couple's psyche. In this way, the woman's disorder can be prevented from developing into post-traumatic stress disorder.

Patterns of acute stress disorder in a sample of blast-injured military service members: A latent profile analysis.

The primary aims of this study were to identify latent profiles of acute stress disorder (ASD) symptoms and to evaluate postconcussive symptom differences across the identified profiles as measured by the Acute Stress Disorder Scale and the Military Acute Concussion Evaluation, respectively. Participants (N = 315) in the current study were predominantly active-duty (75.0%), enlisted (97.8%) males (97.4%) serving in the U.S. Army (87.8%). Approximately, half of the sample reported being married or engaged (51.1%) and was on average 25.94 (SD = 6.31) years old. Participants were referred to the Air Force Theater Hospital, 332nd Air Expeditionary Wing, Joint Base Balad, Iraq, to be evaluated as part of routine clinical assessment for neurocognitive and psychological symptoms following exposure to a blast. A 3-profile solution was identified as the most parsimonious and best-fitting model based on statistical model fit indices. Blast injured service members in Profile 3 had greater ASD total and subscale severity compared to the other 2 subgroups, with effect size estimates largely differing by hyperarousal and reexperiencing symptoms. Furthermore, Profiles 2 and 3 were more likely to demonstrate postconcussive symptoms compared to Profile 1. Findings provide novel information on heterogenous ASD symptom profiles during the acute phase following a blast injury and highlight the relationship between psychological and physical symptoms. Classification of blast-injured service members may help identify at-risk individuals who would benefit from further clinical care and mitigate long-term psychological and neurocognitive issues. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

ПЕРВИННА ПСИХОЛОГІЧНА ДОПОМОГА ПОТЕРПІЛИМ ІЗ СИМПТОМАМИ ГОСТРОГО СТРЕСОВОГО РОЗЛАДУ

Considering the high level of stressogenicity in the conditions of the existing war threat in Ukraine, the ability of psychologists to differentiate post-stress symptoms and to provide initial psychotherapeutic help to the victims in a timely manner is important and relevant. Analyzing the psychotherapeutic experience of Israeli, German, Czech, American, and Lithuanian colleagues, the article highlights the features of initial psychotherapeutic help that is in demand in Ukraine today. The author presents and compares the symptoms that arise as a result of psychological trauma, which are identified in the unified Ukrainian clinical protocol of primary, secondary and tertiary medical care and in IKH-10. The purpose of the article is to determine the psychological features of providing initial psychotherapeutic assistance to victims, in particular to military personnel. Research methods: theoretical analysis of scientific sources, observation of servicemen in hospital conditions, conversations with servicemen and doctors, interviews with foreign colleagues. As a result of theoretical and empirical research, it was found that initial psychological assistance is more effective if it is provided in a timely and comprehensive manner in cooperation with medical assistance; if the recommended exercises are performed systematically by the victim; if a certain algorithm for providing initial psychotherapeutic assistance is used. Conclusions. The author presents his own algorithm for providing initial psychological assistance to military personnel: psychophysiological stabilization – adjustment of emotional balance – restoration of cognitive processes and acquisition of constructive coping strategies – formation of life meanings that provide an opportunity to survive the crisis period of life. In the article, the author also notes the importance of providing psychological first aid to victims of extreme situations in a timely manner, which helps reduce the intensity of symptoms of acute stress disorder and reduces the likelihood of posttraumatic stress disorder.

Cross-sectional survey following a longitudinal study on mental health and insomnia of people with sporadic COVID-19.

BACKGROUNDIn the post-pandemic era, the emergence of sporadic cases of coronavirus disease 2019 (COVID-19) and the scale of the pandemic are unpredictable. Therefore, the impact of sporadic cases of COVID-19 and isolation measures on mental health and sleep in different groups of people need to be analyzed. AIMTo clarify the severity of psychological problems and insomnia of staff and community residents around a hospital with sporadic cases of COVID-19, and their relationship with quarantine location and long-term changes.METHODSA cross-sectional survey was conducted on community residents and medical staff. Many of these medical staff had been subjected to different places of quarantine. Community residents did not experience quarantine. Hospital anxiety and depression scale (HADS), acute stress disorder scale (ASDS) and insomnia severity index (ISI) were used to evaluate anxiety and depression, acute stress disorder symptoms, and the severity of insomnia. Additionally, we conducted a 1-year follow-up study on medical staff, with related scales measurement immediately after and one year after the 2-wk quarantine period.RESULTSWe included 406 medical staff and 226 community residents. The total scores of ISI and subscale in HADS of community residents were significantly higher than that of medical staff. Further analysis of medical staff who experienced quarantine showed that 134 were quarantined in hotels, 70 in hospitals and 48 at home. Among all subjects, the proportions of HADS, ASDS and ISI scores above normal cutoff value were 51.94%, 19.17% and 31.11%, respectively. Multivariable logistic regression analysis found that subjects with higher total ASDS scores had a greater risk to develop anxiety and depression. The total ISI score for medical staff in hotel quarantine was significantly higher than those in home quarantine. Total 199 doctors and nurses who completed the 1-year follow-up study. Compared with baseline, HADS and ASDS scores decreased significantly one year after the end of quarantine, while ISI scores did not change significantly. CONCLUSIONSporadic COVID-19 cases had a greater psychological impact on residents in surrounding communities, mainly manifested as insomnia and depressive symptoms. Hotel quarantine aggravated the severity of insomnia in medical staff, whose symptoms lasted ≥ 1 year.

Racial/ethnic differences in acute and longer-term posttraumatic symptoms following traumatic injury or illness.

Racial/ethnic differences in mental health outcomes after a traumatic event have been reported. Less is known about factors that explain these differences. We examined whether pre-, peri-, and post-trauma risk factors explained racial/ethnic differences in acute and longer-term posttraumatic stress disorder (PTSD), depression, and anxiety symptoms in patients hospitalized following traumatic injury or illness. PTSD, depression, and anxiety symptoms were assessed during hospitalization and 2 and 6 months later among 1310 adult patients (6.95% Asian, 14.96% Latinx, 23.66% Black, 4.58% multiracial, and 49.85% White). Individual growth curve models examined racial/ethnic differences in PTSD, depression, and anxiety symptoms at each time point and in their rate of change over time, and whether pre-, peri-, and post-trauma risk factors explained these differences. Latinx, Black, and multiracial patients had higher acute PTSD symptoms than White patients, which remained higher 2 and 6 months post-hospitalization for Black and multiracial patients. PTSD symptoms were also found to improve faster among Latinx than White patients. Risk factors accounted for most racial/ethnic differences, although Latinx patients showed lower 6-month PTSD symptoms and Black patients lower acute and 2-month depression and anxiety symptoms after accounting for risk factors. Everyday discrimination, financial stress, past mental health problems, and social constraints were related to these differences. Racial/ethnic differences in risk factors explained most differences in acute and longer-term PTSD, depression, and anxiety symptoms. Understanding how these risk factors relate to posttraumatic symptoms could help reduce disparities by facilitating early identification of patients at risk for mental health problems.

Effects of posttraumatic stress and combat losses on the combatants’ resilience

Objectives. At the beginning of the War in Eastern Ukraine, military personnel of the Armed Forces, National Guard of Ukraine (NGU), and soldiers of volunteer battalions, who had no combat experience for the first time faced the death of their comrades. This study aims to determine the effects of posttraumatic stress and combat losses on the mental health of combatants and to develop the typology of their resilience to extreme events.Sample and settings. N = 117 NGU male officers (76% of contract military members and 24% of officers) participated in the study. These combatants were withdrawn from the combat zone in June 2014 due to combat losses and the death of the unit commander.Hypothesis. After participating in hostilities, military personnel developed different types of personality resilience to the effects of traumatic stress.Statistical analyses. The participants’ typification of resilience and adaptation to extreme events was determined by hierarchical cluster analysis. The differences between groups in mean values were determined using Student’s t-test.Results. Four types of personality resilience to combat stressors were identified: “Those who predicted danger” (68.38%), “Those who were open to danger” (21.37%), “Those who identified themself with the role of the victim” (6.83%), and “Those who hid their fear” (3.42%). The results showed that self-identification of a personality with symptoms of acute stress disorder affects the features of the implementation of the anxiety buffer role.Limitations. The conclusions on the anxiety buffer role in the formation of PTSD require clarification and further studies.

Symptom cluster profiles following traumatic orthopaedic injuries

BackgroundMillions of Americans experience traumatic orthopaedic injuries (TOIs) annually. Post-injury symptoms of acute stress disorder (ASD), anxiety, depression, pain, and sleep disturbance are common. Symptoms often present in clusters. Symptom cluster profiles phenotypically characterize TOI survivors’ experiences with clustered symptoms. Expression of brain-derived neurotrophic factor (BDNF) may contribute to the biological underpinnings of symptom cluster profile membership. MethodsWe recruited hospitalized TOI survivors within 72 hours of injury. We measured symptoms of ASD with the Acute Stress Disorder Scale and symptoms of anxiety, depression, pain, and sleep disturbance with Patient-Reported Outcomes Measurement Information System (PROMIS) short forms. We measured serum BDNF concentrations with enzyme-linked immunosorbent assay (ELISA) and identified rs6265 genotypes with TaqMan real-time PCR. We performed latent profile analysis to identify the symptom cluster profiles. We identified the variables associated with symptom cluster profile membership with unadjusted and adjusted multinomial logistic regression. ResultsWe identified 4 symptom cluster profiles characterized by symptom severity that we labelled Physical Symptoms Only, and Mild, Moderate, and Severe Psychological Distress. Age, self-identified Black race, resilience, and serum BDNF concentrations were associated with lower odds, and female sex with higher odds, of being in the Psychological Distress clusters. Clinical characteristics and rs6265 genotypes were not associated with symptom cluster profile membership. ConclusionTOI survivors experience distinct symptom cluster profiles. Sociodemographic characteristics and serum BDNF concentrations, not clinical characteristics, were associated with symptom cluster profile membership. These findings support comprehensive symptom screening and treatment for all TOI survivors and further evaluating BDNF as a biomarker of post-injury symptom burden.