Avoidance Of Thoughts Research Articles

Opinions of Individuals Exposed to Earthquake Regarding Their Psychological Rigidity

This is a qualitative study conducted to evaluate the thoughts of individuals who were exposed to the earthquake that took place on 06.02.2023, centered in Kahramanmaraş, regarding their psychological rigidity. A phenomenological approach was adopted in the study. 14 participants were included in the study. Data were collected by audio recording with a semi-structured interview form. Content analysis technique was used to analyze the data. As a result of the analysis, it was determined that individuals exposed to the earthquake avoided the emotions of joy, happiness, love, sadness, anger and fear. It was determined that thoughts are suppressed and thoughts about the loss of family members are avoided. However, there are also participants who do not have avoidant thoughts or behaviors. Individuals exposed to earthquake reported situations such as fear of loss, nightmares, anxiety, hopelessness, rumination, powerlessness, failure, fear of punishment, burnout, embarrassment, claustrophobia, crying spells, eating problems, increase in alcohol/cigarette use, sleep problems, social isolation, excessive cleaning, staying away from entertainment, and disruption of social relations. In this study, after the trauma experienced, some individuals stated that they became aware of the value of life, created new options, had positive changes in social relations, and change in the perception of self. Considering the results, it is evaluated that practices aimed at increasing psychological flexibility will reduce the negative effects of traumatic experiences and increase psychological resilience in individuals.

Network analysis of posttraumatic stress and posttraumatic growth symptoms among women in subsequent pregnancies following pregnancy loss

BackgroundPregnant women who have undergone pregnancy loss often display both posttraumatic stress (PTS) and posttraumatic growth (PTG). However, the precise relationship and structure of symptomatic levels of PTS and PTG have not been well understood. This study aimed to assess the associations between PTS and PTG symptoms in women during subsequent pregnancies following a previous pregnancy loss.MethodsA total of 406 pregnant women with a history of pregnancy loss were included in this study. The Impact of Events Scale-6 (IES-6) and the Posttraumatic Growth Inventory Short Form (PTGI-SF) were used to assess symptoms of PTS and PTG, respectively. The Graphical Gaussian Model was employed to estimate the network model. Central symptoms and bridge symptoms were identified based on “expected influence” and “bridge expected influence” indices, respectively. The stability and accuracy of the network were examined using the case-dropping procedure and nonparametric bootstrapped procedure.ResultsThe network analysis identified PTG3 (“Ability to do better things”) as the most central symptom, followed by PTS3 (“Avoidance of thoughts”) and PTG6 (“New path for life”) in the sample. Additionally, PTS3 (“Avoidance of thoughts”) and PTG9 (“Perception of greater personal strength”) were bridge symptoms linking PTS and PTG clusters. The network structure was robust in stability and accuracy tests.ConclusionsInterventions targeting the central symptoms identified, along with key bridge symptoms, have the potential to alleviate the severity of PTS experienced by women with a history of pregnancy loss and promote their personal growth.

Predictors of stress among nursing home staff during COVID-19 pandemic

The COVID-19 pandemic has placed immense strain on nursing home staff, necessitating a closer examination of factors contributing to their stress levels. This study investigates predictors of stress among nursing home workers during the pandemic, focusing on psychological constructs such as burnout, sense of coherence (SOC), psychological flexibility, and cognitive fusion. A total of 170 nursing home professionals participated, completing questionnaires assessing various dimensions of burnout, SOC, experiential avoidance, anxious feelings and thoughts, and perceived stress. Results reveal significant correlations between perceived stress and emotional exhaustion, depersonalization, personal accomplishment, SOC comprehensibility, manageability, meaningfulness, experiential avoidance, and anxious feelings and thoughts. Multiple linear regression analysis demonstrates that experiential avoidance, anxious feelings and thoughts, emotional exhaustion, SOC comprehensibility, and personal accomplishment significantly predict perceived stress levels. These findings underscore the importance of addressing maladaptive coping mechanisms and promoting factors such as SOC and personal accomplishment to mitigate stress and burnout among nursing home professionals. Targeted interventions aimed at enhancing psychological flexibility and coping strategies are crucial for supporting the well-being of nursing home staff and ensuring high-quality care for residents amidst the ongoing pandemic challenges.

Symptom structure of posttraumatic stress disorder in workplace trauma: A "distraction-avoidance" pattern.

Individuals who experience a workplace trauma are at a high risk of developing posttraumatic stress disorder (PTSD). Most of these people return to work soon after the trauma (i.e., experience early-stage natural exposure). This study aims to explore the response pattern of workers who have experienced a workplace trauma and early-stage natural exposure through network analysis and provide insights into the potential impact of early-stage natural exposure. Our study included 278 workers directly experiencing the workplace explosion in the Tianjin Economic and Technological Development Zone. A partial correlation network analysis was used to explore the PTSD symptoms relationship and identify central symptoms. The results suggest that emotional numbness, difficulty in concentration, re-experiencing symptoms, and avoidance of thoughts are the most central symptoms, reflecting a "distraction-avoidance" pattern. The current study found that workers who experienced workplace trauma exhibited a "distraction-avoidance" pattern, which helps deepen our understanding of the PTSD network and leads to some suggestions on intervention measures.

Croissance post-traumatique et stratégies de coping chez les sapeurs-pompiers civils français

IntroductionOften faced with potentially traumatic critical incidents, firefighters may experience both negative and positive changes. These include full or partial post-traumatic stress disorder, specific coping strategies and possibly post-traumatic growth. For firefighters, these factors might be related, and their experiences may be possibly different depending on the status of the participants (professional vs volunteer firefighters). ObjectiveThe aim of this study is to explore and predict post-traumatic growth, post-traumatic stress disorder and coping strategies in a sample of French professional and volunteer firefighters. MethodA mixed research methodology was used. The Post-traumatic Stress Disorder Checklist, the Post-traumatic Growth Inventory, the Brief-Cope Inventory, and a semi-structured research interview were used with sixteen participants, divided into two equal groups: a group of eight professional firefighters and a group of eight volunteer firefighters. ResultsPost-traumatic growth was predicted at 63.4 % by traumatic symptomatology (altered arousal and reactivity) and by coping strategies (avoidance and positive thoughts). Spiritual changes predicted post-traumatic distress at 24.9 %. Firefighters who were not parents had more post-traumatic growth and positive thoughts than those who had children. There were no statistical difference between the volunteer and professional firefighter groups. Volunteer firefighters felt more vulnerable to critical incidents than professional firefighters because they have access to fewer effective resources. ConclusionPost-traumatic growth among firefighters could be explained by post-traumatic distress and coping strategies. Other factors influencing post-traumatic growth would need to be investigated (coping flexibility, parenting, a sense of self-efficacy).

The associations of hair cortisol and DHEA with posttraumatic stress disorder symptoms in refugees

BackgroundExposure to traumatic events, ongoing adversity, and posttraumatic stress disorder (PTSD) are associated with altered activity of the hypothalamic-pituitary-adrenal (HPA) axis, but findings are mixed. This may be explained in part by heterogeneity in PTSD symptom profiles. AimThe aim of this study was to investigate the complex relationships between the number of traumatic events and post-displacement stressors, individual symptoms of PTSD, and HPA-axis hormones cortisol and dehydroepiandrosterone (DHEA) in refugees. MethodsAdult (18+ years) Syrian refugees with increased levels of distress participating in a randomized controlled trial completed baseline measures to assess traumatic events (trauma checklist), post-displacement stressors (Post-Migration Living Difficulties checklist), symptoms of PTSD (PTSD Checklist for DSM-5; PCL-5), and provided a hair sample for additional stress hormone analyses. We used R-packages qgraph and bootnet to perform network analysis on the number of traumatic events and post-displacement stressors, individual symptoms of PTSD, and HPA-axis hormones cortisol and DHEA. The final network model was corrected for depression severity. Results115 (53% male, M age = 36.9, SD = 12.7) of 206 participants provided a hair sample. A higher number of traumatic events was directly associated with three symptoms of the PTSD cluster arousal and reactivity, i.e., sleep disturbance, hypervigilance and physiological reactivity, and with three other PTSD symptoms, namely flashbacks, avoidance of reminders, and self-destructive behavior. A higher number of post-displacement stressors was associated with four symptoms of the PTSD cluster cognition and mood, i.e., trauma-related amnesia, negative beliefs, blaming of self/others, and detachment, as well as with intrusive thoughts, sleep disturbance, hypervigilance, and exaggerated startle response. The number of traumatic events and post-displacement stressors were not associated with cortisol or DHEA. Cortisol was positively associated with two symptoms of the PTSD cluster cognition and mood, i.e., negative beliefs and negative trauma-related emotions, and negatively associated with avoidance of reminders. DHEA was positively associated with restricted affect and with three symptoms of the PTSD symptom cluster arousal and reactivity, i.e., irritability/anger, sleep disturbance, and self-destructive behavior, and negatively associated with avoidance of thoughts. ConclusionsThis study demonstrated that exposure to traumatic events and post-displacement stressors is not related to cortisol and DHEA, but that cortisol and DHEA are differentially related to individual symptoms of PTSD. While lower levels of both cortisol and DHEA were associated with increased avoidance, higher levels of cortisol were mostly associated with symptoms of the PTSD cluster cognition and mood and higher levels of DHEA were mostly associated with symptoms of the PTSD cluster arousal and reactivity. These findings contribute to explaining the variability of findings in the literature on HPA-axis activity in PTSD. EthicsThe study was approved by the Research Ethics Review Committee at VU Medical Center, the Netherlands (Protocol ID: NL61361.029.17, 7 September 2017) and prospectively registered online (https://www.trialregister.nl/trial/6665).

61 Subjective PTSD and Cognitive Complaints in Middle Aged Women who were Hospitalized with COVID-19: A Case Series

Objective:hough there is much that is unknown about “post-COVID conditions” the Center for Disease Control (CDC) recognizes that these conditions represent a wide array of new, returning, or ongoing health issues in individuals who have been infected with the novel corona virus, COVID-19. This case series describes the emotional and cognitive screening of three females in their 50's who contracted COVID-19, and were hospitalized during the course of their illness. This case series hopes to provide an initial framework to discuss the recovery trajectory of post-COVID patients who were hospitalized, who have experienced residual post-traumatic stress and cognitive symptoms.Participants and Methods:Three middle-aged female patients (ages 52, 53, 55) were screened in an outpatient post-COVID recovery center for initial and post-COVID emotional, cognitive, and physical symptoms. All three women reported being hospitalized during their illness. The Post-Traumatic Stress Disorder - Primary Care PTSD Screen for DSM-5 (PC-PTSD-5) was administered via clinical interview and the patients were asked about subjective cognitive complaints related to concentration, memory, and word finding.Results:All three women reported persisting cognitive problems, including difficulties with concentration, problems with memory, and word finding difficulties. They also endorsed symptoms of post-traumatic stress, such as avoidance of thoughts and events, as well as recurrent nightmares related to the course of their illness.Conclusions:The CDC notes that there are no tests that specifically evaluate the multitude of post-COVID conditions. Regardless, this case series suggests that emotional and cognitive screeners may assist in treatment planning and support recovery in this population. Future research should examine the exact nature of the relationship between hospitalization, emotional symptoms, and cognitive functioning in post-COVID patients.

Avoidant Automatic Thoughts are Associated with Task Avoidance and Inattention in the Moment

Avoidant Automatic Thoughts are Associated with Task Avoidance and Inattention in the Moment

Improving the efficacy of exposure therapy using projection-based augmented reality for the treatment of cockroach phobia: a randomised clinical trial protocol

IntroductionIn vivo exposure is the treatment of choice for specific phobia (SP), but this technique presents limitations related to access and acceptability. Augmented reality (AR) offers advantages like maximising strategies...

Associations between post-traumatic stress symptoms and quality of life among psychiatric healthcare personnel in China during the COVID-19 pandemic: A network approach.

Post-traumatic stress symptoms (PTSS) are commonly reported by psychiatric healthcare personnel during the coronavirus disease 2019 (COVID-19) pandemic and negatively affect quality of life (QOL). However, associations between PTSS and QOL at symptom level are not clear. This study examined the network structure of PTSS and its connection with QOL in psychiatric healthcare personnel during the COVID-19 pandemic. This cross-sectional study was carried out between March 15 and March 20, 2020 based on convenience sampling. Self-report measures including the 17-item Post-Traumatic Stress Disorder Checklist - Civilian version (PCL-C) and World Health Organization Quality of Life Questionnaire - Brief Version (WHOQOL-BREF) were used to measure PTSS and global QOL, respectively. Network analysis was used to investigate the central symptoms of PTSS and pattern of connections between PTSS and QOL. An undirected network was constructed using an extended Bayesian Information Criterion (EBIC) model, while a directed network was established based on the Triangulated Maximally Filtered Graph (TMFG) method. Altogether, 10,516 psychiatric healthcare personnel completed the assessment. "Avoidance of thoughts" (PTSS-6), "Avoidance of reminders" (PTSS-7), and "emotionally numb" (PTSS-11) were the most central symptoms in the PTSS community, all of which were in the Avoidance and Numbing domain. Key bridge symptoms connecting PTSS and QOL were "Sleep disturbances" (PTSS-13), "Irritability" (PTSS-14) and "Difficulty concentrating" (PTSS-15), all of which were within the Hyperarousal domain. In this sample, the most prominent PTSS symptoms reflected avoidance while symptoms of hyper-arousal had the strongest links with QOL. As such, these symptom clusters are potentially useful targets for interventions to improve PTSS and QOL among healthcare personnel at work under pandemic conditions.

Social self-determination, life practices and economic aspects of preparing women aged 45-57 for retirement

The article presents the results of a sociological study conducted on a target sample of working woman of older middle and pre-retirement age - 45-57 years. The study was aimed at identifying the peculiarities of the perception of the age of «45+» by women themselves in such aspects as shared values and life goals, practices of coping behavior in relation to age and aging, retirement life planning. The issues of preparing for retirement are considered in an extended age range in order to fix the threshold values for the perception of age - to determine at what age the pension begins to be perceived as the immediate life prospect and the reorientation to the tasks of an older age group takes place. According to the results of the study, a predominantly positive perception of the age 45+ age period by women themselves was revealed with a wide variability in self-determination of its content - from a period of rest and stability to professional achievements and personal growth. In general, a positive perception of the one’s age «here and now» is combined with avoidance of thoughts about the upcoming retirement as more or less distant future. A paradox has been that recorded that requires further research: the majority of respondents begin to think about retirement only after reaching the pre-retirement age, while they would like to implement for themselves those methods of preparing for retirement that obviously require a longer planning horizon and a period of accumulation of economic resources than a three-year pre-retirement period.

Intrusive thoughts and distress following amyloid status disclosure in a preclinical Alzheimer’s disease trial: Comparisons across racial and ethnic groups

AbstractBackgroundPreclinical Alzheimer’s disease (AD) trials require biomarker testing and disclosure. Efforts are underway to improve the diversity and inclusivity of enrollment in these trials. While previous studies have shown that disclosure can be performed safely, trialists need a more thorough understanding of whether reactions to AD biomarker disclosure differ among racial and ethnic groups.MethodsUsing data from the Anti‐Amyloid treatment in Asymptomatic AD (A4) study, we analyzed participant responses on the Impact of Events Scale (IES), a 15‐item questionnaire that assesses avoidance and intrusive thoughts after disclosure of amyloid imaging results. We fit a linear regression model to test the hypothesis that mean IES scores differed by racial and ethnic group. Confounding factors included age, sex, years of education, study partner type, family history of AD, and amyloid status. We considered potential effect modification by amyloid status by including an interaction term between race and amyloid group.ResultsIES data were available for 4311 participants (3795 = non‐Hispanic [NH] White; 147 = NH Black; 165 = NH Asian; 135 = Hispanic; 69 = Other). Figure 1 illustrates total IES scores for the groups, stratified by amyloid status. NH Asians demonstrated the highest mean IES among those with elevated amyloid. Hispanics demonstrated the lowest mean IES among those with elevated amyloid, but the highest among those with not elevated amyloid. In a regression model, younger age, female sex, and family history of AD were associated with higher IES. Overall, the association between race and ethnicity groups and IES did not significantly differ by amyloid status (p = 0.200). Among not elevated amyloid individuals, Hispanics had a significantly higher mean IES when compared to NH Whites (est: 2.38; 95% CI: 0.57, 4.19; p = 0.10). Among elevated amyloid individuals, this estimate decreased to ‐1.47 (95% CI: ‐4.36, 1.42; p = 0.319).ConclusionsWhen stratified by amyloid status, all racial and ethnic groups showed higher mean IES in the elevated compared to the not elevated amyloid group, except for Hispanics. This may suggest that, for Hispanics, having an AD biomarker test at all may lead to avoidance and intrusive thoughts, regardless of the specific test result.

Teacher knowledge of anxiety and use of anxiety reduction strategies in the classroom

The current study examined elementary (or primary) school teachers’ knowledge of student anxiety and evidence-based anxiety reduction strategies, whether this knowledge was associated with their use of evidence-based anxiety reduction strategies in the classroom, and correlates of teacher knowledge and use of anxiety reduction strategies in the classroom. Fifty-one volunteer elementary teachers (98% female; 98% White) participated and completed questionnaires about: themselves and work-related factors (e.g., years of teaching experience, self-efficacy), knowledge of student anxiety and anxiety treatment (e.g., core manifestations of anxiety such as physiological arousal, behavioural avoidance, and anxious thoughts), and use of anxiety reduction strategies in the classroom (e.g., relaxation strategies, encouraging the use of coping self-talk, and gradual exposure to feared situations). Results indicated that the average score on the knowledge assessment was 57% and knowledge levels were unrelated to self-reported use of anxiety reduction strategies. The most robust correlate of knowledge of anxiety and use of anxiety reduction strategies was teachers’ perceived personal accomplishment. Findings suggest additional teacher training to increase knowledge about student anxiety and use of evidence-based anxiety reduction strategies in the classroom is warranted.

Dynamics of affect, cognition and behavior in a general population sample of adolescents and young adults with current and remitted anxiety disorders: An Ecological Momentary Assessment study

BackgroundMeasures of dynamic changes in affect/emotions (variability, instability, inertia) have been linked to anxiety disorders (AD). We examine dynamics in affect, cognition and behavior in youth with current and remitted AD. MethodsMental disorders were assessed in a general population sample (N = 1180, age 14–21; Dresden, Germany) using standardized interview. Ecological Momentary Assessment of real-life affect, cognition and behavior took place eight times/day for four days. ResultsIndividuals with current AD (n = 65) compared to healthy controls (HC, n = 531) revealed heightened variability of anxious and manic symptomatology, experiential avoidance, optimism and positive thoughts. Remitted AD (n = 52) showed lower variability of anxious and manic symptomatology and positive thoughts compared to current AD, while no differences were found compared to HC. Current AD and HC differed significantly in instability. Remitted AD showed lower instability of all constructs except for anger than current AD, and higher instability on all constructs except for positive and negative thoughts compared to HC. Current AD showed higher inertia of anger and negative thoughts than HC, and less inertia of positive thoughts than remitted AD. DiscussionAD in youths is particularly linked to higher variability and instability of intertwined emotion-related experiences that partly persist after remission, informing emotion regulation models and interventions.

Features of the Time Perspective of Students with Disabilities

The article presents the results of a study of the features of the time perspective of students with disabilities. It is revealed that the majority of the students with disabilities who were studied are dominated by the hedonistic profile of the time perspective – orientation to fleeting pleasures from the present “here and now”; avoidance of thoughts, meaningfulness of the consequences of their own actions and activities in the future. It is established that the Balanced time perspective of students with disabilities is represented by moderately high indicators of time orientation to the future, low negative past, high hedonistic present. In the profile of an unbalanced time perspective, high indicators of orientation to the negative past, fatalistic and hedonistic present, and low indicators of orientation to the future are expressed. The relationship of a balanced time perspective with the personal qualities of self-determination, self-understanding, self-acceptance, autonomy, self-efficacy and life satisfaction is revealed. Predictors of the time perspective of students with disabilities are: self-acceptance, as a conscious acceptance of the diversity of their own selves; the attitude of others as a resource for developing their own effectiveness and personal autonomy, which allows them to adequately assess their own capabilities, make their own decisions independently and take life responsibly.

Network structure of PTSD symptoms in Chinese male firefighters

The network perspective of mental disorder offers a novel way of understanding the psychopathology of post-traumatic stress disorder (PTSD). In this framework, PTSD may arise from direct interactions between its symptoms. In the present study, we used the Post-Traumatic Stress Disorder Checklist-civilian Version (PCL-C) to investigate the network structure of PTSD symptoms in 994 Chinese male firefighters. We also calculated the micro (i.e., edges weight and node expected influence) and middle (i.e., community) indicators of the final network. Nine strongest edges existed in the final network were from the same dimension of PCL-C, like "avoidance of thoughts" and "avoidance of reminders". Symptoms "emotional reactivity", "avoidance of reminders" and "exaggerated startle response" had the highest expected influence. As for the results of community detection, the spinglass and walktrap algorithm detected the same three communities which are slightly different from the original dimensions of PCL-C (i.e., symptoms "avoidance of thoughts", "avoidance of reminders" and "trauma-related amnesia" of avoidance dimension of PCL-C were added to the intrusion dimension of PCL-C). The present study explored the network structure of PTSD symptoms in Chinese male firefighters and provided several implications for clinical prevention and intervention to address the mental health needs in this special group.

Emotions, Stress and Coping among Healthcare Workers in a Reproductive Medicine Unit during the First and Second COVID-19 Lockdowns.

The impact of the COVID-19 pandemic on global healthcare workers’ (HCWs) mental health has been well documented in the last two years; however, little is known regarding HCWs working in specific healthcare fields. During two subsequent periods of national lockdown in Italy (June–July 2020, T1, and November–December 2020, T2), a total sample of 47 HCWs working in a reproductive medicine hospital unit completed an ad hoc questionnaire for assessing emotional reactions to the pandemic, stress symptoms, and ways of coping. Moderate–high levels of anger and sadness were experienced by 65.9% and 68.1% of the HCWs, respectively, while moderate–high levels of anxiety and fear were experienced by 51.1% and 56.8%, respectively. Higher stress symptoms experienced by HCWs were hypervigilance, avoidance of thoughts and memories, and tiredness/low energy. At T2, levels of hypervigilance, irritability, intrusive thoughts, and detachment were higher than at T1, while avoidance of external triggers decreased. Moderate–high levels of anxiety resulted significantly associated with several symptoms of stress: irritability/fearfulness, depression/hopelessness, tiredness/low energy, problems with concentration, and intrusive thoughts. Regarding coping strategies, HCWs tended to adopt more problem-focused coping (e.g., contributing to improving a situation) and this tendency was higher at T2. Overall findings suggest a risk for the persistence of stress symptoms and, therefore, a risk for a chronic course, which might interfere with the global quality of mental health at work and the care provided to patients. Clinical implications highlight the relevance of implementing support programs for this category of HCWs focused on the elaboration of negative emotions and on fostering adaptive coping strategies.

The Effectiveness of Cognitive-Behavioral Intervention Based on Psychological Capitals on the Experience Avoidance and Suicidal ideations in Female Victims of Domestic Violence

AbstractIntroduction: Violence against women and girls is currently one of the most important and specific forms of violence against human rights.Objectives: The aim of this study was to determine the effectiveness of a cognitive-behavioral intervention based on psychological capital on experience avoidance and suicidal ideations in girls victims of domestic violence in Isfahan.Materials & Methods: The research design was quasi-experimental with a pretest-posttest design with a control group. The statistical population consisted of all girls’ victims of domestic violence in Isfahan who were referred to a Counseling Center in Isfahan in 2019. The sample consisted of 30 girls who were selected by purposive sampling method and randomly assigned to one experimental group (cognitive-behavioral intervention based on psychological capital) and a control group (each consisting of 15 people). The research tools included Beck Scale for Suicidal ideations (BSSI) and Acceptance and Action Questionnaire (AAQ-II). Data were analyzed by SPSS.22 software and univariate analysis of covariance. Results: The findings of this study showed that cognitive-behavioral intervention based on psychological capital was effective on experience avoidance (p <0.001) and suicidal ideation (p <0.001) in girls’ victims of domestic violence in Isfahan.Conclusion: It can be concluded that cognitive-behavioral therapy based on psychological capital is an effective treatment to reduce problems related to experience avoidance and suicidal thoughts of girls’ victims of domestic violence and can be used to improve psychological problems of girls’ victims of domestic violence.

A network analysis of posttraumatic stress symptoms among help-seeking refugees in Kenya

We analyzed the network structure of DSM-IV PTSD symptoms among 2792 help-seeking Central and East African refugees in Kenya exposed to multiple, severe traumatic events and on-going stressors. To some extent, our results reproduced structures identified among clinical populations in Europe, including strong links within traditional symptom clusters, such as between avoidance of thoughts and situations, and hypervigilance and startling. However, we found substantial differences in most central symptoms, with detachment and disinterest far less and emotional numbing and concentration problems more central in our analyses. Our networks did not reproduce the common finding of particularly low centrality of amnesia. We further noted substantive similarities in network structure, but also differences, between refugees living in an urban environment and in refugee camps. Concentration problems were most central among mainly Somali refugees at a refugee camp, and associated with amnesia and sense of foreshortened future, while emotional numbing was the most central symptom among majority Congolese refugees in Nairobi. Our findings highlight the importance of contextual and cultural factors for PTSD symptomatology, and are informative for assessment and treatment among help-seeking refugees.

Network analysis of COVID-19-related PTSD symptoms in China: the similarities and differences between the general population and PTSD sub-population

ABSTRACT Background and Objectives: Prevalent Post-traumatic Stress Disorder (PTSD) negatively affected individuals during the COVID-19 pandemic. Using network analyses, this study explored the construct of PTSD symptoms during the COVID-19 pandemic in China to identify similarities and differences in PTSD symptom network connectivity between the general Chinese population and individuals reporting PTSD. Methods: We conducted an online survey recruiting 2858 Chinese adults. PTSD symptoms were measured using the PCL-5 and PTSD was determined according to the DSM-5 criteria. Results: In the general population, self-destructive/reckless behaviours were on average the most strongly connected to other PTSD symptoms in the network. The five strongest positive connections were found between 1) avoidance of thoughts and avoidance of reminders, 2) concentration difficulties and sleep disturbance, 3) negative beliefs and negative trauma-related emotions, 4) irritability/anger and self-destructive/reckless behaviours, and 5) hypervigilance and exaggerated startle responses. Besides, negative connections were found between intrusive thoughts and trauma-related amnesia and between intrusive thoughts and self-destructive/reckless behaviours. Among individuals reporting PTSD, symptoms such as flashbacks and self-destructive/reckless behaviours were on average most strongly connected to other PTSD symptoms in the network. The five strongest positive connections were found between 1) concentration difficulty and sleep disturbance, 2) intrusive thoughts and emotional cue reactivity, 3) negative beliefs and negative trauma-related emotions, 4) irritability/anger and self-destructive/reckless behaviour, and 5) detachment and restricted affect. In addition, a negative connection was found between intrusive thoughts and self-destructive/reckless behaviours. Conclusion: Our results indicate similarly positive connections between concentration difficulty and sleep disturbance, negative beliefs and negative trauma-related emotions, and irritability/anger and self-destructive/reckless behaviours in the general and PTSD-reported populations. We argue that self-destructive/reckless behaviours are a core symptom of COVID-19 related PTSD, worthy of more attention in future psychiatric programmers.