Posttraumatic Stress Disorder Experience Research Articles

PTSD, depression, and migration-related experiences among Syrian refugees living in camp vs urban settings.

Despite the increased heterogeneity of living conditions of refugees in recent years, there is a lack of robust epidemiological data about the relationship between refugees' mental health and their living contexts. The current study aims to compare frequencies of pre-migration traumatic events and post-migration difficulties between refugees living in camps and those living in cities; and to identify the prevalence of post-traumatic stress disorder (PTSD), depression, and factors associated with them. A field survey was conducted among 1,470 refugees living in camps and urban settings of Turkey. The survey instruments included a socio-demographic form, the Harvard Trauma Questionnaire, the Post-migration Living Difficulties Scale, and the PTSD and depression modules of the Mini-International Neuropsychiatric Interview. Both PTSD and depression were more common in urban settings than in camps. Both disorders were associated with living context and migration-related experiences. Pre-migration traumas were more frequent among refugees living in cities than in those living in camps, while post-migration difficulties were more common in the refugees living in camps. The living context is potentially a critical determinant of refugee mental health. Camp and urban refugees may have different experiences and needs. In particular, refugees living in some urban settings may be at higher risk for having psychological problems.

How is trauma-focused therapy experienced by adults with PTSD? A systematic review of qualitative studies

BackgroundTrauma-focused therapies (TFTs) are first-line treatments for posttraumatic stress disorder (PTSD). However, TFTs are under-utilised, partly due to clinicians’ and patients' fear that TFT is too challenging or harmful. We review the qualitative studies on how adults with PTSD experience TFTs to enhance the understanding of user perspectives, therapeutic processes, and outcomes.MethodsPubMed, PsychINFO and PTSDPubs were searched between October 1st and November 30th, 2021. Study quality assessments were undertaken, and studies were analysed using a descriptive-interpretative approach. Nine studies were included.ResultsThe analysis resulted in the identification of four key domains, representing a temporal sequence of TFT stages: Overcoming ambivalence towards TFT, Experience of treatment elements, Motivation for dropout/retention, and Perceived changes post-treatment.ConclusionAlthough many participants reported high levels of distress and considered dropping out, only a minority did eventually drop out and most patients expressed that the hardships in therapy were necessary for PTSD improvement. Establishing a safe therapeutic environment and working with the ambivalence towards treatment was essential for retention. This review serves a dual purpose, to shed light on diverse TFT experiences found to be important for treatment satisfaction, and to elucidate common treatment patterns. The results can be used in preparing patients for therapy and in training TFT therapists. Studies had moderate to high quality, and more studies of experiences of TFT non-responders and dropouts in a non-veteran population are needed to further our understanding of the utility and limitations of TFTs.

Post-Traumatic Stress Disorder Is Associated With Increased Emergency Department Services and Similar Rates of Opioid Prescriptions Following Primary Total Hip Arthroplasty: A Propensity Matched Analysis

BackgroundThere is a paucity of literature regarding patients who have post-traumatic stress disorder (PTSD) following primary total hip arthroplasty (THA). The purpose of this study was to compare the rates of postoperative complications, prescriptions, health care utilization, and revision arthroplasty of patients who had PTSD undergoing primary THA against a propensity matched control group of patients who did not have PTSD (NPTSD). MethodsThe TriNetX database was queried to identify PTSD patients undergoing primary THA. Patients were then propensity matched in a 1:1 ratio based on twelve preoperative characteristics to a cohort of NPTSD patients. Postoperative prescriptions and rates of health care utilization were analyzed within 5 days, 14 days, and 1 month postoperatively. Complications were analyzed within one month. Revision arthroplasty rates were analyzed within 1 year and 2 years. ResultsA total of 198,560 patients undergoing primary THA were identified. Ultimately, 1,310 PTSD patients were successfully propensity matched to a cohort of 1,310 NPTSD patients. Patients who have PTSD presented to the emergency department at significantly higher rates than NPTSD patients within 14 days and 1 month postoperatively. Within 1 month postoperatively, cohorts were prescribed opioid analgesics at similar rates (P = .709). Patients who had PTSD received more prescriptions per patient compared to NPTSD patients. Patients who had PTSD were also found to have a higher number of total complications per person within 1 month (P = .022). Within 2 years postoperatively, rates of revision hip arthroplasty were comparable between cohorts (P = .912). ConclusionsPatients who have PTSD experience similar rates of revision hip arthroplasty and opioid prescribing compared to NPTSD patients following primary THA; however, within 1 month postoperatively, emergency department visits were greater in PTSD patients. These findings can help delineate early postoperative education and expectations for patients who have PTSD in contrast to other psychiatric diagnoses.

Flexible emotional regulation typology: associations with PTSD symptomology and trait resilience

BackgroundMultiple factors influence posttraumatic stress disorder (PTSD) risk in trauma exposed individuals. An established association exists between trait resilience and decreased PTSD distress and between emotion regulation (ER) ability/flexibility and trait resilience. Typologies in ER ability/flexibility, associated with trait resilience and PTSD experience, could explain the difference in risk. This study aimed to explore the relationship between ER ability, ER flexibility, context sensitivity, resilience, and PTSD.MethodsData from N = 563 trauma exposed UK residents was used in a latent profile analysis (LPA) and membership in the resultant profiles was explored in a logistic regression of sociodemographics, resilience, and PTSD symptomology.ResultsAnalysis showed 2 latent profiles (High Flexibility, Low Flexibility) typified by emotion regulation ability and context sensitivity. Members of the Low Flexibility profile were more likely to be younger, male, endorsing less trait resilience, and experiencing negative cognition/mood and hyperarousal PTSD symptomology.ConclusionsDifficulties in ER ability and flexibility could be improved with targeted learning in a therapeutic or home setting, potentially increasing trait resilience after trauma exposure and reducing PTSD distress.

Exploring Care and Recovery for Individuals With Post-traumatic Stress Disorder: A Scoping Review.

Most people experience trauma at some point in their lives. The sources of trauma can include accidents, natural disasters, physical or sexual assault, combat, torture, or the death of a loved one. Experiencing or witnessing any of these, or other terrifying events, may make one susceptible to developing post-traumatic stress disorder (PTSD), a trauma- and stressor-related mental health condition. The common symptoms and consequences of PTSD include intrusive and distressing thoughts, memories, or flashbacks related to the traumatic event; avoidance of situations, people, or activities that remind one of the traumatic event; irritability, sleep difficulties, or hypervigilance; feelings of guilt, shame, or fear; substance use; strains on relationships; and suicidal thoughts and behaviors. These consequences can have devastating effects on the individual and their family members, friends, co-workers, peers, and communities. Effectively treating PTSD, therefore, is critical not only for the individual but also for the well-being of families, communities, and society at large. However, while treatments for PTSD exist, effectively treating patients with PTSD remains elusive. Further, despite the recognition that people's experiences are essential in understanding PTSD and provide valuable insights into what interventions are effective and how they impact recovery, patient perspectives and experiences of care and recovery have not been well-explored. We conducted a scoping review to address the following question: what is known about the experiences and perspectives of care and recovery for individuals with PTSD? We searched the Medical Literature Analysis and Retrieval System Online (MEDLINE), Embase, American Psychological Association's (APA) PsycInfo, the Cumulative Index to Nursing and Allied Health Literature (CINAHL), PTSDPubs, and Google Scholarfor peer-reviewed and grey literature that used qualitative methods to report on the recovery or care experiences of adults with lived experiences of PTSD. We extracted information about study objectives, study characteristics, and key findings; reported summary statistics; and performed content and thematic analyses. We identified 14 relevant studies that provide insight into the participants' lived experiences and perspectives of PTSD care and recovery. Though limited, the body of literature sheds light on critical themes and processes in the journey of care of PTSD, which we organized into four overarching categories: pre-treatment understanding and experiences of PTSD, the experience of care or treatment, the importance of relationships and social support, and expanding the understandings of recovery. Living with and healing from PTSD are a unique and individualized human experience of developing and redeveloping relationships with oneself, with others, and with society. The recommendations for practice include educating and establishing well-informed support networks for individuals with PTSD, training healthcare practitioners in all aspects of formal and informal PTSD treatment and care needs, ensuring a continuum of care, and understanding the human experience of PTSD.

Gender differences in PTSD severity and pain outcomes: Baseline results from the LAMP trial.

Post-traumatic stress disorder (PTSD) and chronic pain are highly prevalent comorbid conditions. Veterans dually burdened by PTSD and chronic pain experience more severe outcomes compared to either disorder alone. Few studies have enrolled enough women Veterans to test gender differences in pain outcomes [catastrophizing, intensity, interference] by the severity of PTSD symptoms. Examine gender differences in the association between PTSD symptoms and pain outcomes among Veterans enrolled in a chronic pain clinical trial. Participants were 421 men and 386 women Veterans with chronic pain who provided complete data on PTSD symptoms and pain outcomes. We used hierarchical linear regression models to examine gender differences in pain outcomes by PTSD symptoms. Adjusted multivariable models indicated that PTSD symptoms were associated with higher levels of pain catastrophizing (0.57, 95% CI [0.51, 0.63]), pain intensity (0.30, 95% CI [0.24, 0.37]), and pain interference (0.46, 95% CI [0.39, 0.52]). No evidence suggesting gender differences in this association were found in either the crude or adjusted models (all interaction p-values<0.05). These findings may reflect the underlying mutual maintenance of these conditions whereby the sensation of pain could trigger PTSD symptoms, particularly if the trauma and pain are associated with the same event. Clinical implications and opportunities testing relevant treatments that may benefit both chronic pain and PTSD are discussed.

Experiences of Parental PTSD for Children Aged 9–17 in Military and Emergency First Responder Families

AbstractThis study is the first to examine the experiences of children aged 9–17 who have a military or emergency first responder (EFR) parent with post-traumatic stress disorder (PTSD). These experiences of children are important to understand through a lens of intergenerational trauma theory, given the high rates of PTSD in these service populations. Additionally, we need to know if they differ from the experiences of children of civilian parents with PTSD. To examine this, we conducted a total of 17 in-depth interviews in Australia with 5 service parents, 5 co-parents and 7 children aged 9–17 who have a parent who had formerly served in the military or an emergency service. Interviewees were not always from the same family. The families included single-parent, dual-parent, separated, and same-sex families. Gender and service type (military or EFR) were evenly distributed among interviewees. We used a critical humanist approach and undertook a reflexive thematic analysis of the interview data. The major themes were (1) parental emotional extremes, volatility, and unpredictability, (2) changes in home and family relations, (3) impacts on child wellbeing, and (4) PTSD awareness and help-seeking. We found evidence of specific impacts for children related to a combination of parental PTSD symptoms and service conditioning and culture. This study highlights the role of reduced parental capacity in the transmission of trauma from parent to child. It provides an evidence base to direct policy and research into targeted and culturally specific therapeutic interventions and support services for children and parents in service families living with PTSD.

Mental health therapy for veterans with PTSD as a family affair: A qualitative inquiry into how family support and social norms influence veteran engagement in care.

Social support is important for posttraumatic stress disorder (PTSD) recovery and emerging literature indicate that social support could increase engagement in PTSD therapy. However, there is a need to understand how and why family involvement can increase treatment engagement to inform strategies used in clinical practice. This study explores how individuals with PTSD and family members of individuals with PTSD experience therapy and how social interactions help or hinder therapy engagement. We interviewed 18 U.S. military veterans who had been referred for psychotherapy for PTSD in the Veterans Health Administration and 13 family members and used rapid content analysis to identify themes. We found that engaging in therapy was a family-level decision that participants expected to improve family life. Veterans were motivated to seek treatment to protect their relationships with loved ones. Family members generally encouraged veterans to seek treatment. Specifically, family members who viewed PTSD as a treatable illness versus a static aspect of the veteran's personality expressed positive attitudes about the effectiveness of therapy for reducing symptoms. Veterans whose social networks included individuals with prior military or trauma-related experiences reported that their loved ones possessed more understanding of PTSD and described positive subjective norms around therapy. Family members are often embedded in the therapy process because PTSD has a profound impact on the family. Positive subjective norms for therapy are created by family encouragement and may influence veteran perceptions about the value of treatment. Family members should be engaged early in mental health therapy and to the extent desired by the patient and family member. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Post-traumatic stress disorder (PTSD), cognitive control, and perceived seizure control in patients with epilepsy: An exploratory study

Epilepsy is often linked to various psychiatric symptoms, with anxiety, depression, and interictal dysphoric disorders being the most prevalent. Few studies have investigated posttraumatic stress disorder (PTSD) in epilepsy, but they suggest a notable prevalence of PTSD. PTSD is known to be associated with cognitive impairments, particularly memory and executive functions.Our proposed exploratory study aims to investigate executive attentional control and emotional inhibition in patients with drug-resistant epilepsy (DRE) who exhibit PTSD symptoms compared with a healthy control group. Additionally, some PWE can manage their seizures using emotional and cognitive strategies, we find it relevant to explore the connection between their regulation abilities, cognitive control performance, and PTSD symptoms.We included 54 PWE and 60 healthy participants. They completed anxiety and depression scales as well as two questionnaires assessing PTSD symptoms and a questionnaire that measured the perceived self-control of seizures. We measured executive control using an executive control task (Attention Network Test, ANT) and an emotional Go/No-Go task. We found a positive correlation between PTSD scores (PDS-5) and performance at the ANT task. In contrast, in the emotional inhibition (Go/No-Go) task, behavioral inhibition errors were positively correlated with PTSD scores, specifically with hypervigilance symptoms in PTSD+ patients. There was a positive correlation between response reaction times in an aversive condition and PTSD scores: the more severe the PTSD symptoms, the faster the PWE identified stimuli in the angry face condition of the Go/No-Go task. Regarding perceived seizure control, we found correlations between alertness and PTSD symptoms associated with seizure anticipation during the inter- and peri-ictal periods. Patients with PTSD symptoms reported better seizure control.Our findings suggest that epilepsy patients with PTSD experience cognitive changes such as heightened executive attentional control, weakened emotional inhibition, and improved seizure control perception.

Experiencing racial discrimination increases vulnerability to PTSD after trauma via peritraumatic dissociation

ABSTRACT Background: Racial discrimination is a traumatic stressor that increases the risk for posttraumatic stress disorder (PTSD), but mechanisms to explain this relationship remain unclear. Peritraumatic dissociation, the complex process of disorientation, depersonalization, and derealization during a trauma, has been a consistent predictor of PTSD. Experiences of frequent racial discrimination may increase the propensity for peritraumatic dissociation in the context of new traumatic experiences and contribute to PTSD symptoms. However, the role of peritraumatic dissociation in the relationship between experiences of discrimination and PTSD has not been specifically explored. Objective: The current study investigated the role of peritraumatic dissociation in the impact of racial discrimination on PTSD symptoms after a traumatic injury, and the moderating role of gender. Method: One hundred and thirteen Black/African American individuals were recruited from the Emergency Department at a Level I Trauma Center. Two weeks after the trauma, participants self-reported their experiences with racial discrimination and peritraumatic dissociation. At the six-month follow-up appointment, individuals underwent a clinical assessment of their PTSD symptoms. Results: Results of longitudinal mediation analyses showed that peritraumatic dissociation significantly mediated the effect of racial discrimination on PTSD symptoms, after controlling for age and lifetime trauma exposure. A secondary analysis was conducted to examine the moderating role of gender. Gender was not a significant moderator in the model. Conclusions: Findings show that racial discrimination functions as a stressor that impacts how individuals respond to other traumatic events. The novel results suggest a mechanism that explains the relationship between racial discrimination and PTSD symptoms. These findings highlight the need for community spaces where Black Americans can process racial trauma and reduce the propensity to detach from daily, painful realities. Results also show that clinical intervention post-trauma must consider Black Americans’ experiences with racial discrimination.

Trauma, Mind Style, and Unreliable Narration in Toni Morrison’sHome

ABSTRACTThis article provides a twofold reading of Toni Morrison’s novel Home. In the first instance, the stylistic representation of post-traumatic stress disorder (PTSD) is explored in relation to Frank’s mind style; this is done through a focused examination on passages related to Frank’s misremembered murder of a girl during his time as a soldier in the Korean War. Frank’s guilt and faulty memories, and his lingering experience of PTSD, lead to the issue of narrative unreliability. This article shows how not just Frank himself but also the unspecified third-person narrator is just as unreliable as Frank, if not more so. The seemingly contentious relationship between Frank and the other narrator ultimately leads to Frank’s realization about his hand in the murder of the Korean girl, and hence to a coming to terms with and recovery from war-induced PTSD.

A study of post-traumatic stress disorder in schizophrenic patients 35 years after experiencing the Tangshan earthquake.

This study aimed to investigate the relationship between dissociative experiences, post-traumatic stress disorder (PTSD), and psychiatric symptoms exhibited byschizophrenic patients 35 years after the Tangshan earthquake. Seventy-one schizophrenic patients who had experienced the Tangshan earthquake were selected and evaluated by the Post-traumatic DissociativeExperience Questionnaire (PDEQ), thPTSD Checklist-Civilian Version (PCL-C), and the Positive and Negative Symptom Scale (PANSS). The score of Group B (re-experiencing symptoms) in PCL-C was significantly positively correlated with age and significantly negatively correlated with the course of schizophrenia. Both gender and marriage were significantly positively correlated with the score of PCL-C Group D (irritability symptoms caused by hyperarousal). The PDEQ score was negatively correlated with thecourse of schizophrenia and positively correlated with the presence of sleep difficulties. Significant differences were foundbetween the PCL-C scores of the positive and negative symptoms of the three core symptom groups; the positive rate of Group B was significantly higher than that of Group D, and the positive rate of Group C was significantly higher than that of Group D. The PCL-C total score was positively correlated with the negative symptom factor score of PANSS; Group C's symptoms were significantly negativelycorrelated with the positive factor score of PNASS; andGroup D's' symptoms were significantly negatively correlated with the PANSS total score and thepositive factor score. When consiering patients with schizophrenia post the Tangshan earthquake, age, gender, and marital status were all positively correlated with PTSD. The course of schizophrenia was negatively associated with PTSD and dissociative experiences. PTSD was positively correlated with the negative symptoms of schizophrenia and negatively correlated with the positive symptoms of schizophrenia. Thus, the conditions and symptoms of PTSD may interact with those of schizophrenia.

The Indirect Effects of Proximal Stressors Associated with Posttraumatic Stress Symptoms Severity among Sexually Victimized Sexual Minority Women: A Cross-Sectional Path Analysis.

Sexual minority women (SMW) are at risk for sexual victimization and stressors specifically related to their minority identity (e.g., discrimination). However, SMW experience posttraumatic stress disorder (PTSD) at rates beyond what may be explained by elevated risk for sexual victimization alone. This study aimed to examine the impact of stigma on PTSD symptoms among SMW survivors of sexual victimization. Results indicate that in relation to minority-specific distal stressors (i.e., heterosexist experiences), both minority-specific and general proximal stressors (i.e., internalized heterosexism, negative posttraumatic cognitions) indirectly affected PTSD symptom severity among this cross-sectional sample of sexually victimized SMW.

Misguided social support? How Danish veteran families affected by PTSD experience formal and informal social support

Existing literature highlights that posttraumatic stress disorder (PTSD) after military deployment not only affects the formerly deployed veteran, but when the veteran has a family, has detrimental effects on the entire family. While research suggests that social support can have a positive mediating effect on the impact of PTSD, we know little about how veteran families experience the impact of PTSD, and how this relates to their experiences of formal and informal social support. Drawing on a hermeneutic phenomenological framework, we addressed this gap by exploring perceptions and experiences of formal and informal social support in six Danish veteran families. We found veteran families to be closely involved with formal and informal social support structures. However, the social support available did not always match their needs or understandings of helpful social support. Some families experienced an overload of social support or perceived the provided social support as inappropriate or prescribed. We construe these three types of social support as misguided social support—support that did little to meet their actual needs—on the contrary. We discuss how families come to experience and understand social support as an overload, or as inappropriate or prescribed; and what it takes for social support not to be experienced as misguided. We suggest that in order to meet families’ social support needs, tailored social support and improved collaboration between (in)formal social support structures and veteran families may promote more meaningful social support of veteran families affected by PTSD.

Nutritional Psychiatry Integrated Framework: Exploration of Nutrition and Co-occurring Bipolar Disorder and Post-traumatic Stress Disorder

Nutritional psychiatry advancements are needed in understanding the effects of food nutrients on co-occurring psychiatric conditions particularly bipolar disorder and post-traumatic stress disorder (PTSD). Food nutrients contribute to the increase and decrease of symptoms in psychiatric conditions. Bipolar disorder and PTSD are frequently co-occurring and significantly impact moods, how the brain processes information, and psychological stressors. Individuals diagnosed with bipolar disorder and PTSD experience increased risks of suicide and are more likely to have unhealthy dietary habits. Understanding the appropriate nutrients to consume and avoid may contribute to promising outcomes for psychiatric conditions. Advancements in awareness of food nutrition are necessary to manage not only psychiatric conditions but also medical conditions. Omega-3 fatty acids, minerals (magnesium and zinc), pro-biotics, B vitamins, vitamins C and D, large neutral amino acids, specifically tryptophan and tyrosine, and branched-chained amino acids, antioxidants found in fruits and vegetables, and fatty acids have been linked to improved outcomes in the management of bipolar disorder and PTSD symptoms. Foods associated with poor prognosis have been linked to caffeine, alcohol, sugar, salt, processed foods, and artificial additives. This research contributes to the body of literature by exploring a link between food nutrients and bipolar disorder and PTSD because no known study has explored a co-occurring treatment intervention for such psychiatric conditions, and introduces the Nutritional Psychiatry Integrated Framework (NPIF)with a patient-centered focus which makes this research compelling. Advancements in understanding the effects of nutritional psychiatry associated with symptoms of bipolar disorder and PTSD may introduce innovative dietary and psychological treatment approaches.

Outcomes of pregnant women with coronavirus disease 2019 (COVID-19) admitted to intensive care unit in Uzbekistan

Aim. The present study aimed to investigate outcomes of pregnant women with severe acute respiratory syndrome coronavirus 2 (SARS‑CoV‑2 or COVID-19) in the intensive care unit (ICU). Methods. A total of 3080 pregnant women infected with COVID-19 during treatment were studied in the maternity ward of the Zangiota-1 Republican Specialized Infectious Diseases Hospital from December 2020 to January, 2022. At the time of admission of patients to the hospital, 28.9% of women were in the first trimester of pregnancy, 34.3% and 36.8% were in the second and third trimester of pregnancy, respectively. 1980 cases (64.3%) showed a moderate course of pneumonia and in 48% (1478 cases), bilateral pneumonia was detected. At the same time, 60.0% of patients had lung damage (up to 50%) according to CT dataset. Results. A total of 677 out of 3080 pregnant women with COVID-19 pneumonia (22.0%) needed treatment at the ICU. 490 cases out of 677 patients showed severe clinical course of COVID-19, while 277 cases (41%) showed multiple organ dysfunction syndrome (MODS). Of 277 MODS cases, 209 (75.4%) were those in the third trimester of pregnancy and 170 (61.4%) had initially severe clinical picture of COVID-19. Mortality rate in ICU was 9.4% (64 cases out of 677) while 56.6% experienced post-traumatic stress disorder (PTSD) at baseline, 26.7% had general anxiety disorders, and 16.7% (113 of 677) of women experienced depression symptoms. In the postpartum period, 46.1% (312 of 677) cases showed combinations of PTSD, anxiety and depression according to the combined Patient Health Questionnaire Anxiety and Depression Scale (PHQ-ADS) assessment, which was typical for women with severe and extremely severe COVID-19, preterm birth, miscarriages and perinatal mortality. Conclusion. The ICU hospitalization rate for COVID-19 pneumonia in pregnant women was 22.0%, among which the vast majority (72.4%) were cases with severe clinical course of COVID-19 and PTSD (56.6%). Women in the third trimester of pregnancy were most susceptible to developing MODS and severe COVID-19 pneumonia. Recommendation. In promoting pregnant women's mental and physical health, understanding the characteristics of psycho-emotional stress disorders during the COVID-19 pandemic and learning how to deal with them is critical.

Post-traumatic stress disorder is associated with a higher rate of polypectomy independent of an increased frequency of colonoscopy in Australian veterans: a retrospective review.

Post-traumatic stress disorder (PTSD) is associated with extensive physical comorbidities, including lower gastrointestinal symptoms. Diagnostic uncertainty and poor therapeutic responses may result in more frequent colonoscopies than clinically necessary. Polypectomy is standard practice when polyps are identified, and if PTSD is a risk factor for polyp formation, one would expect a higher rate of polyp detection and removal in veterans with PTSD than those without PTSD. To determine the association between PTSD and the rate of colonoscopy and polypectomy in Australian veterans. Diagnostic and therapeutic colonoscopy rates in Australian male Veterans aged ≥50 years were examined by reviewing case records of veterans who accessed Department of Veterans' Affairs funded health services between 1 January 2013 and 31 December 2018. A total of 138 471 veterans was included, of whom 28 018 had a diagnosis of PTSD; 56.4% were aged ≥65 years. Twenty-one percent of the entire cohort underwent at least one colonoscopy during the study period. Increased rates of diagnostic colonoscopy and polypectomy were associated with the presence of PTSD across all age brackets. The effect was empirically large as veterans with PTSD experience colonoscopy rates 76-81% greater than those without PTSD. Similarly, veterans with PTSD experienced polypectomy rates 76-81% greater than veterans without PTSD, and this increase persisted when controlling for the increased number of diagnostic colonoscopies they undergo. The presence of PTSD has a marked impact on colonoscopy rates in Australian veterans. The increased polypectomy rate independent of increased colonoscopy rate suggests that PTSD is a risk factor for colonic polyp formation.

GÖÇ, RUH SAĞLIĞINI NASIL ETKİLEMEKTEDİR?

A geographical relocation of people for a permanent or temporary duration in order to spend all or part of their future lives is characterized as migration. War, ethnic or religious conflicts, political pressure, inequities, unemployment rates, poverty, hope for improved living standards, familial reasons, proximity to health care services, climate, and natural catastrophes are all factors that might lead to migration. People who have changed their environment owing to migration experience post-traumatic stress disorder, anxiety disorder, depression disorder, schizophrenia and related disorders, culture shock, handicap, abuse, and suicidal ideation/attempt, especially among migrating women and children. Immigrants' mental difficulties are treated with psychosocial intervention methods such as individual/group trauma-focused cognitive behavioral therapy, narrative exposure therapy, and Eye Movement Desensitization and Reprocessing (EMDR). However, the number of evidence-based psychological intervention programs for immigrants must be increased. The goal of this review is to look at the research that indicates immigrant mental problems.

Childhood adversity, combat experiences, and military sexual trauma: a test and extension of the stress sensitization hypothesis.

U.S. veterans report high rates of traumatic experiences and mental health symptomology [e.g. posttraumatic stress disorder (PTSD)]. The stress sensitization hypothesis posits experiences of adversity sensitize individuals to stress reactions which can lead to greater psychiatric problems. We extend this hypothesis by exploring how multiple adversities such as early childhood adversity, combat-related trauma, and military sexual trauma related to heterogeneity in stress over time and, subsequently, greater risk for PTSD. 1230 veterans were recruited for an observational, longitudinal study. Veterans responded to questionnaires on PTSD, stress, and traumatic experiences five times over an 18-month study period. We used latent transition analysis to understand how heterogeneity in adverse experiences is related to transition into stress trajectory classes. We also explored how transition patterns related to PTSD symptomology. Across all models, we found support for stress sensitization. In general, combat trauma in combinations with other types of adverse experiences, namely early childhood adversity and military sexual trauma, imposed a greater probability of transitioning into higher risk stress profiles. We also showed differential effects of early childhood and military-specific adversity on PTSD symptomology. The present study rigorously integrates both military-specific and early life adversity into analysis on stress sensitivity, and is the first to examine how sensitivity might affect trajectories of stress over time. Our study provides a nuanced, and specific, look at who is risk for sensitization to stress based on previous traumatic experiences as well as what transition patterns are associated with greater PTSD symptomology.

Examining the psychometric properties of the PCL-5 in a black community sample using item response theory

Black Americans are more likely to be exposed to certain types of traumatic events and experience posttraumatic stress disorder (PTSD) compared to other racial groups. Consequently, sound assessment of PTSD in this underserved and understudied population is necessary to develop and accurately answer research questions about etiology and intervention efficacy. However, the item-level psychometric properties of one of the most commonly used assessment tools, the PTSD Checklist for DSM-5 (PCL-5), has yet to be examined among Black Americans. To address this gap, we used item response theory (IRT) to assess item difficulty and discrimination in a sample of Black American adults (n = 307). We employed a graded response model with all 20 items of the PCL-5 loading on to a latent PTSD factor. At clinically significant levels of PTSD, the most discriminating items were flashbacks, inability to experience positive emotions, and nightmares and the least discriminating items were cued emotional distress, diminished interest, and hypervigilance. These results emphasize the importance of flashbacks, inability to experience positive emotions, and nightmares and deemphasize the importance of hypervigilance and sleep difficulties when assessing for clinically significant symptoms of PTSD in Black Americans. Treatment implications include a nuanced approach towards hypervigilance.