Development Of Posttraumatic Stress Disorder Research Articles

Compassion buffers the association between trauma exposure and PTSD symptom severity: Findings of a cross-sectional study

To advance intervention science dedicated to improve refugees’ mental health, a better understanding of factors of risk and resilience involved in the etiology and maintenance of post-traumatic stress disorder (PTSD) is needed. In the present study, we tested whether empathy and compassion, two trainable aspects of social cognition related to health, would modulate risk for PTSD after war-related trauma. Fifty-six refugees and 42 migrants from Arabic-speaking countries reported on their trauma experiences, PTSD symptoms, and perceived trait empathy and compassion. They further completed the EmpaToM, a naturalistic computer task measuring behavioral empathy and compassion. Moderation analyses revealed that behavioral, but not self-reported compassion was a significant moderator of the trauma-PTSD link. Trauma was more strongly related to PTSD symptoms when individuals had low (β =.59, t = 4.27, p <.001) as compared to high levels of behavioral compassion. Neither self-reported nor behavioral empathy moderated the trauma-PTSD link (β =.24, t = 1.57, p =.120). Findings indicate that the ability to go beyond the sharing of others’ suffering and generate the positive feeling of compassion may support resilience in the context of trauma and subsequent development of PTSD. Hence, compassion may be a suitable target for prevention and intervention approaches reducing PTSD symptoms after trauma.

Sex Differences in Response Inhibition–Related Neural Predictors of Posttraumatic Stress Disorder in Civilians With Recent Trauma

BackgroundFemales are more likely to develop posttraumatic stress disorder (PTSD) than males. Impaired inhibition has been identified as a mechanism for PTSD development, but studies on potential sex differences in this neurobiological mechanism and how it relates to PTSD severity and progression are relatively rare. Here, we examined sex differences in neural activation during response inhibition and PTSD following recent trauma. MethodsParticipants (n = 205, 138 female sex assigned at birth) were recruited from emergency departments within 72 hours of a traumatic event. PTSD symptoms were assessed 2 weeks and 6 months posttrauma. A Go/NoGo task was performed 2 weeks posttrauma in a 3T magnetic resonance imaging scanner to measure neural activity during response inhibition in the ventromedial prefrontal cortex, right inferior frontal gyrus, and bilateral hippocampus. General linear models were used to examine the interaction effect of sex on the relationship between our regions of interest and the whole brain, PTSD symptoms at 6 months, and symptom progression between 2 weeks and 6 months. ResultsLower response inhibition–related ventromedial prefrontal cortex activation 2 weeks posttrauma predicted more PTSD symptoms at 6 months in females but not in males, while greater response inhibition–related right inferior frontal gyrus activation predicted lower PTSD symptom progression in males but not females. Whole-brain interaction effects were observed in the medial temporal gyrus and left precentral gyrus. ConclusionsThere are sex differences in the relationship between inhibition-related brain activation and PTSD symptom severity and progression. These findings suggest that sex differences should be assessed in future PTSD studies and reveal potential targets for sex-specific interventions.

Differences in predictive factors for post-traumatic stress disorder encompassing partial PTSD and full PTSD: a cross-sectional study among individuals exposed to the November 13, 2015 Paris attacks.

When faced with a surge of physically injured individuals, especially following a traumatic event like an attack, frontline practitioners prioritize early triage. Detecting potential psychological injuries soon after such events remains challenging. Some individuals might develop post-traumatic stress disorder (PTSD) according to DSM-V criteria. Others may exhibit PTSD symptoms without meeting full diagnostic criteria, termed partial or sub-syndromal PTSD, a less-explored area in literature. This study aims to identify predictive factors for both full and partial PTSD. In a cohort of victims of the 2015 Paris attacks, multinomial logistic regressions explored predictive factors for partial or full PTSD status 8 to 18 months post-attacks. Analyses considered pre, peri, and posttraumatic factors chosen from literature review and univariate analysis within each group. Within the cohort, 50 individuals showed no signs of PTSD, 35 experienced partial PTSD, and 30 presented with full PTSD. After logistic regression, risk factors associated with full PTSD included a history of trauma (OR = 1.30, CI [1.02-1.66], p < 0.05), the intensity of peri-traumatic physical reactions (OR = 1.22, CI [1.09-1.36], p < 0.001), the difficulties in suppressing intrusive thoughts (OR = 1.11, CI [1.02-1.21], p < 0.013). Only the intensity of peri-traumatic physical reactions emerged as a risk factor for partial PTSD (OR = 1.13, [CI 1.02-1.24], p < 0.001). This study revealed that a history of trauma, the intensity of peri-traumatic physical reactions (e.g., tachycardia, trembling, flushes, numbness.), and the difficulties in suppressing intrusive thoughts constitute risk factors for the development of full PTSD. Moreover, the study identified that only the intensity of peri-traumatic physical reactions emerged as a risk factor for partial PTSD. These findings seem to underscore the significance of peri-traumatic experiences in influencing the development of post-traumatic stress symptoms. This study emphasizes the significance of examining peri-traumatic reactions in PTSD development, suggesting its potential as a straightforward screening tool for post-traumatic stress disorder. It also underscores the influence of prior traumatic experiences, before de novo traumatization, in shaping vulnerability to PTSD and illuminates the crucial role of compromised control of intrusive thoughts that could perpetuate PTSD.

A comparison of the psychometric properties of a person-administered vs. automated screening tool for posttraumatic stress disorder (PTSD) in traumatically injured patients

BackgroundThe American College of Surgeons Committee on Trauma (ACS-CoT) mandated that trauma centers have mental health screening and referral protocols in place by 2023. This study compares the Injured Trauma Survivor Screen (ITSS) and the Automated Electronic Medical Record (EMR) Screen to assess their performance in predicting risk for posttraumatic stress disorder (PTSD) within the same sample of trauma patients to inform trauma centers’ decision when selecting a tool to best fit their current clinical practice. MethodsThis was a secondary analysis of three prospective cohort studies of traumatically injured patients (N = 255). The ITSS and Automated EMR Screen were compared using receiver operating characteristic curves to predict risk of subsequent PTSD development. PTSD diagnosis at 6-month follow-up was assessed using the Clinician Administered PTSD Scale for DSM-5. ResultsJust over half the sample screened positive on the ITSS (57.7%), while 67.8% screened positive on the Automated EMR Screen. The area under the curve (AUC) for the two screens was not significantly different (ITSS AUC = 0.745 versus Automated EMR Screen AUC = 0.694, p = 0.21), similar performance in PTSD risk predication within the same general trauma population. The ITSS and Automated EMR Screen had similar sensitivities (86.5%, 89.2%), and specificities (52.5%, 40.9%) respectively at their recommended cut-off points. ConclusionBoth screens are psychometrically comparable. Therefore, trauma centers considering screening tools for PTSD risk to comply with the ACS-CoT 2023 mandate should consider their local resources and patient population. Regardless of screen selection, screening must be accompanied by a referral process to address the identified risk.

Yoga resilience training to prevent the development of posttraumatic stress disorder in active-duty first responders: A cluster randomized controlled trial.

Evidence on effective prevention of posttraumatic stress disorder (PTSD) is sparse, particularly among first responders. This study evaluated the effectiveness of a Tactical Mind-Body Resilience Training program on PTSD symptoms in first responders. Active-duty first responders (n = 80; Mage = 41.8 years, 82.5% men) were randomized to the intervention group or the waitlist control condition. PTSD symptoms as measured by the PTSD-8 were the primary outcome assessed at postintervention and at 3-month follow-up. Secondary outcomes were cognitive and emotional coping strategies, resilience, somatic symptoms, work performance, and sickness absence. At postintervention, the intervention group had significantly reduced PTSD symptoms compared to the control group (d = -0.26, difference = -2.52, 95% confidence interval [CI] [-4.93, -0.11], p = .040); however, this difference was attenuated at 3-month follow-up (d = -0.07, difference = -1.41, 95% CI [-3.83, 1.01], p = .248). The intervention group had significant improvements in cognitive reappraisal and resilience at postintervention compared to the control group, which were sustained at 3 months. The remaining secondary outcomes had statistically nonsignificant improvements. This workplace-delivered intervention shows potential in preventing the development of PTSD in first responders. Further research is needed on maintaining long-term benefits of this training. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Dorsal hippocampal astrocytes mediate the development of heroin withdrawal-enhanced fear learning

There is a significant co-occurrence of opioid use disorder (OUD) and post-traumatic stress disorder (PTSD) in clinical populations. However, the neurobiological mechanisms linking chronic opioid use, withdrawal, and the development of PTSD are poorly understood. Our previous research has shown that proinflammatory cytokines, expressed primarily by astrocytes in the dorsal hippocampus (DH), play a role in the development of heroin withdrawal-enhanced fear learning (HW-EFL), an animal model of PTSD-OUD comorbidity. Given the role of astrocytes in memory, fear learning, and opioid use, our experiments aimed to investigate their involvement in HW-EFL. Experiment 1 examined the effect of withdrawal from chronic heroin administration on GFAP surface area and volume, and identified increased surface area and volume of GFAP immunoreactivity in the dentate gyrus (DG) following 24-hour heroin withdrawal. Experiment 2 examined astrocyte morphology and synaptic interactions at the 24-hour withdrawal timepoint using an astroglial membrane-bound GFP (AAV5-GfaABC1D-lck-GFP). Although we did not detect significant changes in surface area and volume of GfaABC1D-Lck-GFP labelled astrocytes, we did observe a significant increase in the colocalization of astrocyte membranes with PSD-95 (postsynaptic density protein 95) in the DG. Experiment 3 tested if stimulating astroglial Gi signaling in the DH alters HW-EFL, and our results demonstrate this manipulation attenuates HW-EFL. Collectively, these findings contribute to our current understanding of the effects of heroin withdrawal on astrocytes and support the involvement of astrocytes in the comorbid relationship between opioid use and anxiety disorders.

Profiles of posttraumatic stress disorder and negative world assumptions in treatment-seeking refugees

ABSTRACT Background: Refugees often suffer from trauma-related psychopathology, specifically posttraumatic stress disorder (PTSD). Negative world assumptions are strongly correlated with the development, course, and severity of PTSD. Objective: This study aimed to investigate whether there are distinct profiles of PTSD and negative world assumptions (NWA) and examine whether trauma load, torture, and gender differentially predict such symptom profiles. Method: In a sample of 225 treatment-seeking refugees who had resettled in the Netherlands, latent profile analysis was used to identify subgroups of patients sharing the same profile of PTSD and NWA symptoms. Predictors of profile membership were analyzed via multinomial logistic regression. Results: A three-profile solution yielded the best model fit: a low PTSD/low NWA profile (23.6%), a high PTSD/high NWA profile (41.8%), and a high PTSD/low NWA profile (34.7%). Participants who reported a higher trauma load, were more likely to be part of the high PTSD/high NWA profile or the high PTSD/low NWA profile in comparison to low PTSD/low NWA profile. Participants who reported having experienced torture were more likely to be part of the high PTSD/high NWA profile in comparison to low PTSD/low NWA profile. Gender did not differentiate between the profiles. Conclusions: This study reveals that among treatment-seeking refugees resettled in the Netherlands, there are distinct profiles of PTSD and NWA. These profiles indicate that PTSD and NWA are not uniformly experienced among refugees, emphasizing the diversity in their psychological responses to trauma. Among individuals experiencing severe PTSD symptoms, a subgroup was identified of individuals who additionally exhibited negative assumptions about themselves, others, and the world. Recognizing this heterogeneity is crucial in both research and clinical practice, particularly in the context of refugee mental health. Directions for future research are discussed.

Line- and sex-dependent effects of juvenile stress on contextual fear- and anxiety-related behavior in high- and low-alcohol-preferring mouse lines

Juvenile stress (JS) is a known risk factor for the development of alcohol use disorder (AUD) and post-traumatic stress disorder (PTSD), both of which are frequently co-morbid. Data suggest there may be common, genetically-influenced biological responses to stress that contribute to the development of both AUD and PTSD. The present study investigated the impact of JS on contextual fear learning and extinction, as well as corticosterone (CORT) responses before and after JS, before and after contextual fear conditioning (CFC), and after fear extinction in male and female high-alcohol-preferring (HAP2) and low-alcohol-preferring (LAP2) mouse lines. We also measured unconditioned anxiety-related behavior in the light-dark-transition test before CFC. HAP2 and LAP2 mice did not differ in fear acquisition, but HAP2 mice showed faster fear extinction compared to LAP2 mice. No effects of JS were seen in HAP2 mice, whereas in LAP2 mice, JS reduced fear acquisition in males and facilitated fear extinction in females. Females showed greater fear-related behavior relative to males, regardless of subgroup. HAP2 males demonstrated more anxiolytic-like responses than LAP2 males and LAP2 females demonstrated more anxiolytic-like responses than LAP2 males in the light-dark transition test. HAP2 and LAP2 mice did not differ in CORT during the juvenile stage; however, adult LAP2 mice showed greater CORT levels than HAP2 mice at baseline and after CFC and extinction testing. These findings build upon prior work in these unique mouse lines that differ in genetic propensity toward alcohol preference and provide new information regarding contextual fear learning and extinction mechanisms theorized to contribute to co-morbid AUD and PTSD.

The effects of a combination of cognitive interventions and loving-kindness meditations (C-METTA) on guilt, shame and PTSD symptoms: results from a pilot randomized controlled trial

ABSTRACT Background: Trauma-related guilt and shame are crucial for the development and maintenance of PTSD (posttraumatic stress disorder). We developed an intervention combining cognitive techniques with loving-kindness meditations (C-METTA) that specifically target these emotions. C-METTA is an intervention of six weekly individual treatment sessions followed by a four-week practice phase. Objective: This study examined C-METTA in a proof-of-concept study within a randomized wait-list controlled trial. Method: We randomly assigned 32 trauma-exposed patients with a DSM-5 diagnosis to C-METTA or a wait-list condition (WL). Primary outcomes were clinician-rated PTSD symptoms (CAPS-5) and trauma-related guilt and shame. Secondary outcomes included psychopathology, self-criticism, well-being, and self-compassion. Outcomes were assessed before the intervention phase and after the practice phase. Results: Mixed-design analyses showed greater reductions in C-METTA versus WL in clinician-rated PTSD symptoms (d = −1.09), guilt (d = −2.85), shame (d = −2.14), psychopathology and self-criticism. Conclusion: Our findings support positive outcomes of C-METTA and might contribute to improved care for patients with stress-related disorders. The study was registered in the German Clinical Trials Register (DRKS00023470).

Symptoms of posttraumatic stress, anxiety, and depression, along with their associated factors, among Eritrean refugees in Dabat town, northwest Ethiopia, 2023

BackgroundRefugee populations are forcibly displaced from their homes as a consequence of natural disasters and armed conflicts. Eritreans, initially displaced to the Maiayni camp within the Tigray region, have faced further relocation to Dabat town due to the conflict between the Tigray People Liberation Front (TPLF) and Ethiopian government forces. Subsequently, another conflict has arisen between the Amhara Popular Force (Fano) and Ethiopian government forces in Dabat town, disrupting its stability. These collective challenges in the new environment may contribute to the development of symptoms such as posttraumatic stress disorder (PTSD), anxiety, and depression. Currently, there is a lack of available data on these symptoms and their associated variables in Dabat Town. Thus, the objective of this study was to assess the prevalence of PTSD, anxiety, and depression symptoms, along with associated factors, among Eritrean refugees in Dabat town, northwest Ethiopia. This will provide significant evidence for developing and implementing mental health intervention strategies that specifically address the particular difficulties faced by refugees.MethodA community-based cross-sectional study was carried out from July 25 to September 30, 2023, in the Eritrean refugee camp in Dabat town. A systematic random sampling method was employed to select a total of 399 Eritrean refugees with 100 response rate. Data were collected using the standard validated Depression, Anxiety, and Stress Scale (DASS-21) questionnaire, which included socio-demographic characteristics. Summary statistics such as frequency and proportion were utilized to present the data in tables and figures. Binary logistic regression was employed to identify associated factors, and variables with a p-value (p ≤ 0.05) were considered statistically significant factors.ResultThe findings of this study indicated that 45% (95% CI: 35.6-48.23), 33.6% (95% CI: 31.66–37.45), and 37.3% (95% CI: 35.56–40.34) of the participants had symptoms of depression, anxiety, and PTSD, respectively. Sex, age, employment status, lack of food or water, experience of torture or beating, and imprisonment emerged as statistically significant predictors of depression. Employment status, murder of family or friends, rape or sexual abuse, torture or beating, and lack of housing or shelter were statistically significantly associated with anxiety. PTSD was found to be significantly associated with sex, length of stay at the refugee camp, lack of housing, shelter, food, or water, experience of rape or sexual abuse, abduction, employment status, and murder of family or friends.Conclusions and recommendationThe results of this study revealed that more than one-third of Eritreans living in the refugee camp in Dabat town had symptoms of PTSD, anxiety, and depression. This prevalence is higher than the previously reported studies. Various factors, including age, gender, monthly income, unemployment, experiences of rape or sexual abuse, witnessing the murder of family or friends, being torched or beaten, imprisonment, and deprivation of basic needs such as food, shelter, and water, were identified as contributors to the development of depression, anxiety, and PTSD. This research underscores the need for both governmental and non-governmental organizations to secure the provision of essential necessities such as food, clean water, shelter, clothing, and education. This study also suggested that Eritrean refugees be legally protected from rape, sexual abuse, arson, detention without cause, and kidnapping. Moreover, the study calls for health service providers to develop a mental health intervention plan and implement strategies to deliver mental health services at healthcare facilities for Eritrean refugees in the Dabat town Eritrean refugee camp.

An investigation of laboratory-based positive and negative emotional suppression in relation to posttraumatic stress disorder symptom clusters.

Emotional suppression is a clinically significant aspect of emotion regulation with robust associations to psychopathology, including posttraumatic stress disorder (PTSD). Despite the fast-growing body of literature highlighting the role of positive emotion regulation difficulties in the development and maintenance of PTSD, extant work on emotional suppression and PTSD has almost exclusively focused on the role of negative emotions. The present study aimed to advance this literature by examining the associations between PTSD symptom clusters and participants' use of state emotional suppression during a laboratory task designed to elicit negative or positive emotions. Participants were 108 community women (Mage = 39.55; 33% Black/African American) currently experiencing intimate partner violence (IPV) by a male partner and using substances. Participants were interviewed using a structured diagnostic assessment for PTSD and reported on state emotional intensity and emotional suppression following idiographic negative or positive emotion inductions. Results of the moderation analyses showed that, when controlling for state emotional intensity, women experiencing clinical levels of PTSD symptom Clusters B (intrusive recollections), D (negative alterations in cognitions and mood), and E (alterations in arousal and reactivity) were significantly more likely to utilize emotional suppression, but only in the context of positive-not negative-emotions. Findings provide evidence for a link between PTSD and positive emotional suppression among women currently experiencing IPV by a male partner and using substances, highlighting positive emotional suppression as a potential target in PTSD treatment for IPV populations with comorbid substance use concerns. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

A Neuroanatomic and Pathophysiologic Framework for Novel Pharmacological Approaches to the Treatment of Post-traumatic Stress Disorder.

Post-traumatic stress disorder (PTSD) is a debilitating disorder inflicting high degrees of symptomatic and socioeconomic burdens. The development of PTSD results from a cascade of events with contributions from multiple processes and the underlying pathophysiology is complex, involving neurotransmitters, neurocircuitry, and neuroanatomical pathways. Presently, only two medications are US FDA-approved for the treatment of PTSD, both selective serotonin reuptake inhibitors (SSRIs). However, the complex underlying pathophysiology suggests a number of alternative pathways and mechanisms that may be targets for potential drug development. Indeed, investigations and drug development are proceeding in a number of these alternative, non-serotonergic pathways in an effort to improve the management of PTSD. In this manuscript, the authors introduce novel and emerging treatments for PTSD, including drugs in various stages of development and clinical testing (BI 1358894, BNC-210, PRAX-114, JZP-150, LU AG06466, NYV-783, PH-94B, SRX246, TNX-102), established agents and known compounds being investigated for their utility in PTSD (brexpiprazole, cannabidiol, doxasoin, ganaxolone, intranasal neuropeptide Y, intranasal oxytocin, tianeptine oxalate, verucerfont), and emerging psychedelic interventions (ketamine, MDMA-assisted psychotherapy, psilocybin-assisted psychotherapy), with an aim to examine and integrate these agents into the underlying pathophysiological frameworks of trauma-related disorders.

Potential causal association between gut microbiome and posttraumatic stress disorder

BackgroundThe causal effects of gut microbiome and the development of posttraumatic stress disorder (PTSD) are still unknown. This study aimed to clarify their potential causal association using mendelian randomization (MR).MethodsThe summary-level statistics for gut microbiome were retrieved from a genome-wide association study (GWAS) of the MiBioGen consortium. As to PTSD, the Freeze 2 datasets were originated from the Psychiatric Genomics Consortium Posttraumatic Stress Disorder Working Group (PGC-PTSD), and the replicated datasets were obtained from FinnGen consortium. Single nucleotide polymorphisms meeting MR assumptions were selected as instrumental variables. The inverse variance weighting (IVW) method was employed as the main approach, supplemented by sensitivity analyses to evaluate potential pleiotropy and heterogeneity and ensure the robustness of the MR results. We also performed reverse MR analyses to explore PTSD’s causal effects on the relative abundances of specific features of the gut microbiome.ResultsIn Freeze 2 datasets from PGC-PTSD, eight bacterial traits revealed a potential causal association between gut microbiome and PTSD (IVW, all P < 0.05). In addition, Genus.Dorea and genus.Sellimonas were replicated in FinnGen datasets, in which eight bacterial traits revealed a potential causal association between gut microbiome and the occurrence of PTSD. The heterogeneity and pleiotropy analyses further supported the robustness of the IVW findings, providing additional evidence for their reliability.ConclusionOur study provides the potential causal impact of gut microbiomes on the development of PTSD, shedding new light on the understanding of the dysfunctional gut-brain axis in this disorder. Our findings present novel evidence and call for investigations to confirm the association between their links, as well as to illuminate the underlying mechanisms.

The role of environmental sensitivity in post-traumatic stress symptoms in Lebanese children and adolescents.

Children differ substantially in their sensitivity to the quality of their environment. Some are more sensitive and more likely to develop Post-Traumatic Stress Disorder (PTSD) in response to Childhood Adversities (CAs), but might also benefit more from Positive Home Experiences (PHE). The aim of this study is to investigate the role of Environmental Sensitivity (ES), CAs and PHEs in PTSD development in children and adolescents. Data was collected from N = 2,569 children/adolescents. PTSD symptoms, CAs, PHEs and ES were assessed with self-report measures. We found that higher ES and CAs emerged as risk factors for PTSD development whereas higher levels of PHEs protected against PTSD. ES moderated the effects of CAs (β = 1.08, p < .001) on PTSD symptoms in the total sample. This moderating effect was more pronounced in girls, suggesting that highly sensitive girls with high childhood adversities were more likely to have higher PTSD symptoms than girls with low levels of sensitivity (β = 1.09, p < .001). In conclusion, Environmental Sensitivity played an important role as a risk factor for PTSD and as a moderating factor that accentuated the main effects of childhood adversities, particularly in girls.

The role of self-criticism and self-compassion in the development of PTSD among midwives

ObjectiveHealthcare providers might develop emotional distress following direct and indirect exposure to traumatic events. Evidence shows that midwives, who care for women in complicated situations, are often exposed to circumstances that have a potential to lead to a variety of psychological reactions, including symptoms identified with post-traumatic stress disorder (PTSD). Nevertheless, the positive-healthy context in which childbirth is mainly perceived raises questions regarding the protective role of personality traits, which are related to processing methods of stress and pain, in the development of PTSD among this unique population. This study aimed to explore the associations between traits such as self-compassion, self-criticism, resilience, cognitive thinking, and pain catastrophizing and PTSD symptoms among Israeli midwives. SettingUsing a quantitative cross-sectional study,123 midwives from ten hospitals in Israel anonymously reported their characteristics and severity of stress and/or PTSD symptoms by filling out the Psychopathy Checklist questionnaire. Analysis of personality traits was performed via the following questionnaires: Self-Compassion Scale - Short Form, Depressive Experiences Questionnaire - Self Criticism, and the Connor-Davidson Resilience Scale. Additionally, we measured the level of catastrophizing pain by employing the Pain Catastrophizing Scale questionnaire. FindingsMost of the midwives reported existing post-trauma symptoms, among them 11.38% had been diagnosed with PTSD. Severity of the PTSD correlated with their self-criticism and the pain catastrophizing rates. Additional examination of the involvement of personality traits showed that midwives with high self-criticism, low mental resilience, besides a high rate of pain catastrophizing, were more vulnerable to developing PTSD. ConclusionsThe findings can help to refine the understanding regarding the involvement of midwives' personality characteristics in the process of PTSD onset. Vulnerable midwives have been identified as those at risk to develop PTSD symptoms. Implications for practiceThe clinical significance of these insights is to promote the ability to identify midwives who are at risk to develop PTSD. Furthermore, this information might help to produce training programs and a support network to empower self-compassion and mental resilience, and to minimize self-criticism in order establish a support network, which would help to deal with the difficult experiences they face at work.

Meta-analysis of risk factors for posttraumatic stress disorder in myocardial infarction.

The aim of this study was to identify the risk factors for posttraumatic stress disorder in patients with myocardial infarction. Cohort, case-control, and cross-sectional studies on posttraumatic stress disorder (PTSD) in patients with myocardial infarction were searched from PubMed, Embase, Cochrane Library, Web of Science, China Biomedical Literature Database, China National Knowledge Infrastructure, Wanfang Data Knowledge Service Platform, and Technology Journal database. The Newcastle-Ottawa Quality Assessment Scale was used to score the quality of the included literature in the cohort and case-control studies, and the cross-sectional studies were scored using the American Agency for Health Care Quality and Research cross-sectional study quality evaluation criteria. The literature was screened independently by 2 researchers, and if there was no consensus, the inclusion was decided by a third party. The extraction content included first author, publication year, sample size, PTSD assessment tool, PTSD assessment time, PTSD incidence, influencing factors, and study type. Meta-analysis of data was performed using Stata17.0 software. Ten studies were included, including 2 cohort studies, 7 cross-sectional studies, and 1 case-control study, with a total sample size of 2371 patients, including 26 influencing factors. The results of meta-analysis showed that the prevalence of PTSD in patients with myocardial infarction was 21.2%. Statistically significant influencing factors were gender (odd ratio [OR] = 3.124), neuroticism score (OR = 2.069), and age (OR = 0.913). The prevalence of PTSD in patients with myocardial infarction in China is higher than that in other countries. Female and neurotic personality are risk factors for developing PTSD in patients with myocardial infarction, and old age is protective factor for developing PTSD in patients with myocardial infarction. Targeted measures should be taken to prevent and reduce the occurrence and development of PTSD in patients with myocardial infarction in the future.

Anxiety sensitivity, finding the body, and posttraumatic stress disorder in suicide-bereaved treatment-seeking adults.

Those bereaved by suicide are at greater risk of prolonged distress compared to those bereaved by other modes of death. Trauma- and emotion-related factors may increase this vulnerability. Finding the body of the deceased may intensify postsuicide distress. Anxiety sensitivity, fear of one's anxiety-related symptoms, has been positively associated with posttraumatic stress disorder (PTSD) in other trauma populations but has not been studied in the suicide bereaved. This study examined the relationships among finding the body, anxiety sensitivity, and PTSD in a treatment-seeking, suicide-bereaved sample (N = 50). Pretreatment baseline data on demographics, the Anxiety Sensitivity Index, and the PTSD Checklist were analyzed. Younger age (r = -.31, p = .03), being a person of color (r = -.32, p = .02), and fewer days since the loss (r = -.30, p = .03) were associated with greater PTSD. Controlling for age, race, and days since the loss, PTSD was unrelated to finding the body, F(1, 45) = 0.01, p = .92, but was positively associated with anxiety sensitivity (pr = .32, p = .03). In simultaneous regression analyses, age, race, days since the loss, finding the body, and anxiety sensitivity accounted for 33% of the variance in PTSD, F(2, 44) = 4.29, p = .003; anxiety sensitivity was the only significant predictor of PTSD symptoms (β = .36, t = 2.35, p = .02). Anxiety sensitivity has important implications for the development and maintenance of PTSD in the suicide bereaved and should be assessed and targeted in suicide postvention. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Attentional bias modification and attention control training in PTSD: a systematic review and meta-analysis.

Cognitive models of post-traumatic stress disorder (PTSD) highlighted the effect of maladaptive cognitive processing in the development and maintenance of PTSD. PTSD is related to attentional bias (AB) toward threatening stimuli and greater attentional bias variability (ABV). Attentional bias modification (ABM) and attention control training (ACT) have demonstrated the effect of improving PTSD, but the results of randomized controlled trials (RCTs) are controversial. The current study aimed to evaluate the extent of evidence supporting the efficacy of ABM in the treatment of PTSD. Systematic review and meta-analysis. We searched PUBMED, PsycINFO, EMBASE, ClinicalTrials.gov, and the Cochrane Central Register of Controlled Trials for articles published between 1980 and 2022. RCTs of ABM for adult participants with PTSD symptoms were identified. The primary outcome was changes in PTSD severity, and the second outcome was changes in AB and ABV. Trial quality was assessed using the Cochrane Risk of Bias Tool. Publication bias was assessed using the Doi plot and Luis Furuya-Kanamori (LFK) index. Eight RCTs comparing the effect of ABM to ACT were included in the review, and six studies were meta-analyzed. Meta-analysis favored ACT in improving PTSD symptoms and ABV, and the effect size was large. ABM and ACT demonstrated similar effects in improving AB. ACT should not only be seen as a control training condition but also has therapeutic values. However, since the current meta-analysis only included a limited number of studies, further research was still needed to examine the clinical value of ACT in PTSD treatment.

The Association between COVID-19-Related Discrimination and Probable Post-Traumatic Stress Disorder among Patients with COVID-19 in Sapporo, Japan.

BackgroundDisasters such as earthquakes, terrorism, and pandemics have triggered post-traumatic stress disorder (PTSD), and discrimination against the affected individuals has been linked to the development of PTSD. However, there is limited evidence regarding the association between discrimination against coronavirus disease 2019 (COVID-19) patients and probable PTSD in Japan.MethodsWe conducted a cross-sectional study utilizing a web-based questionnaire targeting individuals who had contracted the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in Sapporo City. A total of 4247 individuals with laboratory-confirmed SARS-CoV-2 infection spanning from February 2020 to February 2022 completed the questionnaire (response rate: 15.9%). Probable PTSD was measured using the three-item Posttraumatic Diagnostic Scale. The stratified exact logistic regression was applied to calculate the odds ratios (OR) of probable PTSD for COVID-19-related discrimination with adjusted factors.ResultsThis study included 3626 patients who had a history of SARS-CoV-2 infection. Among them, 321 patients (8.9%) experienced COVID-19-related discrimination. The prevalence of probable PTSD was 19.6% (63/321) among the patients who experienced COVID-19-related discrimination, and 4.6% (152/3305) among those who had not encountered such discrimination. The adjusted OR of COVID-19-related discrimination for probable PTSD was 4.68 (95% confidence interval [95% CI], 3.36-6.53). The population attributable fraction of probable PTSD attributable to COVID-19-related discrimination among COVID-19 patients was estimated to be 23.4% (95% CI, 21.5-25.3).ConclusionThe comprehensive epidemiological survey of COVID-19 patients in Japan showed that COVID-19-related discrimination was associated with a higher prevalence of probable PTSD. Mitigating discrimination could be helpful to attenuate PTSD in future pandemics.

Cognitive Models Explaining Post-Traumatic Stress Disorder and Cognitive Therapy Methods Frequently Used in Trauma Victims

Trauma is considered a significant event that causes intense fear and anxiety and frequent avoidance owing to its unfolding and persistence. Post-traumatic stress disorder (PTSD) may develop when the distress and symptoms caused by the development and acute nature of the trauma do not resolve spontaneously over time. Incompatibility with one's existing schemas and the emergence of new nonfunctional schemas are both effective in the development of PTSD. Thus, while working with trauma victims, attempts to restructure the existing traumatic cognitions by doing assessments about traumatic cognitions play an effective role in reinterpreting the traumatic experience. This review study examines the nature of trauma, the expression of trauma according to cognitive therapy, widely recognized cognitive models explaining trauma, and frequently utilized effective cognitive methods for trauma victims. The impact of cognitive processes on the development and continuation of trauma was expressed, and the models of different experts explaining trauma were discussed in detail. Furthermore, considering the contribution of cognitive therapy intervention techniques for PTSD in healthily reevaluating the trauma, cognitive therapy methods that are thought to contribute to both the victim and mental health professionals are included.