Posttraumatic Stress Disorder Factors Research Articles

Determinants of post-traumatic stress disorder among survivors of road traffic accidents in dessie comprehensive specialized hospital North-East Ethiopia

BackgroundPost-traumatic stress disorder is the most common mental disorder occurring among survivors of road traffic accidents. However, it remains under-explored and is not taken into account in the health policies of Ethiopia. Therefore, this study aimed to identify determinant factors of post-traumatic stress disorder among survivors of road traffic accident patients in Dessie Comprehensive Specialized Hospital, North-East Ethiopia.MethodsA facility-based unmatched case–control study design was employed from February 15 to April 25, 2021, in Dessie Comprehensive Specialized Hospital, with a total sample size of 139 cases and 280 controls selected by using a simple random sampling technique. Data were collected by pretested, interview with a structured questionnaire. The data were entered using Epi-Info, then exported and analyzed using STATA. The bi-variable and multivariable binary logistic regression model was used to identify determinant factors of post-traumatic stress disorder among survivors of road traffic accident. Adjusted odds ratio with a 95% confidence level was used as a measure of association. Variables with a p-value less than 0.05 were considered as statistically significant.ResultA total of 135 cases and 270 controls participated in this study, with a response rate of 97% and 96%, respectively. In the final multivariable analysis, being male [AOR = 0.43, 95% CI: 0.32–0.99], primary educational status [AOR = 3.4, 95% CI: 1.04–11], presence of personal psychiatric history [AOR = 2.12, 95% CI: 1.17–3.92], presence of fracture [AOR = 2.41, 95% CI: 1.2–4.8], witness of death [AOR = 2.25, 95% CI: 1.26–4.30], presence of comorbidity [AOR = 2.29, 95% CI: 1.28–4], good social support [AOR = 0.71, 95% CI: 0.12–0.68] were significantly associated with post-traumatic stress disorder among survivors of road traffic accident patients.ConclusionPTSD following road traffic accidents is common. A multi-disciplinary approach was therefore essential in the management of road traffic accident survivors at the orthopedic and trauma clinics. Patients with poor social support, bone fracture, witnessed death, comorbidity, and females should be routinely screened for post-traumatic stress disorder in all road traffic accident survivors.

Symptoms and risk factors of depression and PTSD in the prolonged COVID-19 pandemic: a longitudinal survey conducted from 2020 to 2022 in Japan

BackgroundThe present study aimed to explore changes in depression and posttraumatic stress disorder (PTSD) among the general population during the prolonged COVID-19 pandemic and to investigate risk factors and adaptive/nonadaptive strategies.MethodsA web-based longitudinal survey was conducted across five timepoints from 2020 to 2022 in Japan. Depressive symptoms were measured using the Patient Health Questionnaire-9 (PHQ-9), PTSD was measured using Impact of Event Scale-Revised (IESR), and coping strategies were measured using Brief Coping Orientation to Problems Experienced (Brief COPE). Higher scores of PHQ-9 and IESR indicate more symptoms and Higher score of Brief COPE indicate that these means of coping are used very frequently.ResultsA total of 1,366 participants (mean age = 52.76, SD = 15.57) were analyzed. Regarding levels of depression, PHQ-9 scores in 2022 were lower than in 2020 and 2021 (all p < 0.01). Regarding levels of PTSD, IESR scores in 2022 were lower than in 2021 among females (p < 0.001). Being younger (β = -0.08 and − 0.13, both p < 0.01) and engaging in self-blame (β = 0.12 and 0.18, both p < 0.01) increased PHQ-9 scores regardless of sex. For males, not working (β = 0.09, p = 0.004) and having suffered an economic impact (β = 0.07, p = 0.003) were risk factors for depressive symptoms, and active coping (β = -0.10, p = 0.005) was associated with decreased depressive symptoms. For females, substance use (β = 0.07, p = 0.032) and behavioral disengagement (β = 0.10, p = 0.006) increased depressive symptoms, and females did not show strategies that decreased the symptoms.ConclusionsLevels of depression might have increased in the early stages of the pandemic and decreased in January 2022. Although males need to improve their economic situation to decrease depressive symptoms, adaptive strategies might be difficult to identify due to the prolonged pandemic among both sexes. In addition, the pandemic might be a depressive event but not a traumatic event among the general population, at least in Japan.

Posttraumatic stress disorder symptoms among Chinese college students following the COVID-19 outbreak.

This study examined the prevalence of posttraumatic stress disorder (PTSD) symptoms in college students 1 month after the lockdown of Wuhan to identify possible risk factors for PTSD symptoms in a cross-sectional study. Out of 10,502 who responded, 9,274 students impacted by the COVID-19 pandemic were included in our study. PTSD symptoms was evaluated by the Impact of Event Scale-revised (IES-R). Anxiety/depression symptoms were evaluated by the Kessler Psychological Distress Scale (K10). Personality traits, coping style, and social support were assessed by the Eysenck Personality Questionnaire-Revised Short Scale for Chinese (EPQ-RSC), the Simplified Coping Style Questionnaire (SCSQ), and the Social Support Rating Scale (SSRS). Logistic regression analysis was utilized to further explore risk factors for PTSD symptoms. More than 1 month after the COVID-19 outbreak, 13.1% of college students developed PTSD symptoms, indicating that COVID-19 associated stressful experiences were connected with PTSD symptoms. After the COVID-19 outbreak, subjects with symptomatologic PTSD symptoms were more likely to experience strained relationships with their family, to have close contact with COVID-19 patients and to drop out of college. The logistic regression model demonstrated the association factors of PTSD symptoms. Neuroticism, psychoticism and an avoidant coping style were associated with increased risk for PTSD symptoms, while an active coping style was protective against PTSD symptoms during this pandemic. The results showed that PTSD symptoms was prevalent in Chinese college students 1 month after the COVID-19 outbreak. Effective psychological support work should be carried out accordingly.

Prevalence and Associated Factors of Post-traumatic Stress Disorder in Gangjeong Village Residents, Jeju-do, Korea

IntroductionMost studies on post-traumatic stress disorder (PTSD) have involved a small sample size and a specific traumatic event, with few studies reporting on subjects who have been continuously exposed to a traumatic event. Timely assessment and treatment are crucial for individuals chronically exposed to a traumatic event.Objectives This study investigated the prevalence of PTSD and associated factors in all residents of Gangjeong village, who, recently, have been exposed to a traumatic event for a prolonged period.MethodsThe subjects of this study were the residents of Gangjeong village, who have been exposed to a traumatic event related to the construction of the Jeju Civilian-Military Complex Port. The survey included items related to general characteristics and PTSD symptoms, which were assessed using the Impact of Event Scale-Revised, Korean version.ResultsThe prevalence of PTSD symptoms was 26.8% (95% confidence interval=23.54–30.04). Multivariate logistic regression analysis identified age, length of residence, and marital status as factors significantly associated with PTSD symptoms.ConclusionsThe prevalence of PTSD symptoms was higher among the study population than in the general population. Economically active age groups, people exposed to the traumatic event throughout their duration of residence in the village, and unmarried individuals were found to be more likely to develop PTSD symptoms. Mental, social, and financial support should be directed to the affected groups of individuals.Disclosure of InterestNone Declared

The Functional Significance of a Novel Conceptualization of Intrusion Symptoms of PTSD

IntroductionIntrusion symptoms are a core defining feature of posttraumatic stress disorder (PTSD). It was recently proposed that intrusions may be comprised of two distinct underlying processes: internally-cued intrusions (e.g., memories), and externally-cued intrusions (e.g., reactions to one’s environment). Preliminary empirical evidence demonstrated superior fit of an 8-factor model of PTSD, separating intrusion symptoms into an in internally-cued and externally-cued symptom cluster over other factor models of PTSD. However, whether these two clusters are related differently with functional outcomes was not investigated previously.ObjectivesThis is the first study to examine the functional correlates of the internally-cued and externally-cued intrusion symptom clusters in PTSD to assess whether separating intrusion symptoms into these two clusters is of clinical and scientific relevance.MethodsParticipants included 7460 veterans discharged from 40 VA PTSD residential treatment programs (RRTPs) across the United States in fiscal years 2018 through 2020. Demographic data was collected using a self-report form during the admission process. Symptoms of PTSD, anxiety, depression, and emotional and physical functioning were assessed with the PTSD Checklist for DSM-5, the Patient Health Questionnaire-9, the Generalized Anxiety Disorder Questionnaire-7, and the corresponding subscales of the Short Form 12-item Health Survey, respectively. Latent network modeling was used to test the fit of the 8-factor model of PTSD. Structural equation modelling was used to investigate the associations between the factors of PTSD and the functional outcomes. All associations were adjusted for demographic characteristics, and standardized.ResultsThe 8-factor model, with separate intrusion factors, showed good model fit (CFI 0.965, RMSEA 0.045, χ2 2453.022, and P &lt;.001). Internally-cued intrusions were negatively associated with physical functioning and positively with emotional functioning. No relationship with depression or anxiety was found. In contrast, externally-cued intrusions were negatively associated with emotional functioning and positively associated with anxiety, but not related to physical functioning and depression.ConclusionsThis study provides initial support for the functional utility of distinguishing between internally- and externally-cued intrusions in veterans with PTSD. Consequently, researchers focusing on the biological underpinnings of intrusion symptoms (e.g., in imaging or genetic studies) should account for differences in the origin of the cue triggering intrusions. Our findings are of potential clinical relevance as they might help patients adapt their coping strategies for intrusions depending on whether they originate internally (e.g., thoughts) or externally (e.g., loud noises).Disclosure of InterestNone Declared

Risk factors of post-traumatic stress disorder after hospitalization in a pediatric intensive care unit: a systematic literature review.

The number of studies on post-traumatic stress disorder after hospitalization in a pediatric intensive care unit raised since 2004. The objective of this systematic review was to summarize and critically examine the literature about risk factors for these children to develop post-traumatic stress disorder following admission to an intensive care unit. The data sources were PubMed, Cochrane, Web of Science, PsycInfo, SUDOC, Scopus, and ScienceDirect. Studies were selected if they were in English or French and published between 01/01/2004 and 31/01/2022. Studies were excluded if patients were less than 1month old and if no post-traumatic stress disorder was found. The internal validity and risk of bias were assessed using the National Institutes of Health Study Quality Assessment Tools for observational studies and the Ottawa Scale was used for the interventional study. The search yielded 523 results and 22 articles met inclusion criteria. Three common risk factors were identified from the data: parental post-traumatic stress disorder (especially in mothers), severity of illness and delusional memories. Internalizing behavior in children, acute parent and child stress, emergency admission and sepsis are also potential risk factors that require further investigation. The prevalence of this pathology is substantial (between 14 and 36%) and increasing awareness among pediatricians and psychologists seems necessary. Prevention programs are being studied to reduce the incidence of post-traumatic stress disorder in this population. Child and adolescent psychiatry liaison should collaborate with pediatric teams to support this objective.

Assessment of genetic variants in D2 dopamine receptor (DRD2) gene as risk factors for post-traumatic stress disorder (PTSD) and major depressive disorder (MDD): A systematic review and meta-analysis

BackgroundMany studies have performed assessments of genetic variants in the D2 dopamine receptor (DRD2) gene as risk factors for post-traumatic stress disorder (PTSD) and major depressive disorder (MDD). However, the results are inconsistent. This meta-analysis aimed to systematically summarize published data to evaluate the reliable association between the DRD2 genetic variants and the risk of PTSD and MDD. MethodsA systematic literature search was conducted using the Web of Science, PubMed, Google Scholar, Excerpta Medica Database (EMBASE), Springer, ScienceDirect, Wiley Online Library, Cochrane Central Register of Controlled Trials, Chinese Biomedical Literature Database (CBM), WANFANG Data, CQVIP, and Chinese National Knowledge Infrastructure (CNKI) databases before January 1st, 2022. ResultsA total of 27 genetic variants in the DRD2 gene were retrieved, and 7 of them met the inclusion criteria for meta-analysis. Our meta-analysis results indicated that the rs1800497 (TaqIA) polymorphism was significantly associated with the increased risk of PTSD (Dominant model (A1A1 + A1A2 vs. A2A2): OR = 1.49, 95 % CI, 1.08–2.04 Z = 2.46, P = 0.014). Subgroup analysis for ethnicity suggested that a significantly increased risk of PTSD was observed in Asians (Dominant model (A1A1 + A1A2 vs. A2A2): OR = 1.39, 95 % CI, 1.08–1.79, Z = 2.60, P = 0.009) and Caucasians (Dominant model (A1A1 + A1A2 vs. A2A2): OR = 1.87, 95 % CI 1.02–3.41, Z = 2.04, P = 0.042). Meanwhile, we detected significant association strengths between the rs1799978 and rs2075652 polymorphisms in the DRD2 gene and MDD (for rs1799978, Homozygote comparison (GG vs. AA): OR = 0.60, 95 % CI = 0.37–0.97, Z = 2.08, P = 0.038; for rs2075652, Homozygote comparison (AA vs. GG): OR = 1.82, 95 % CI = 1.32–2.50, Z = 3.67, P < 0.001). Our cumulative meta-analyses indicated a continuous trend toward association strength with PTSD and MDD. ConclusionsThis meta-analysis indicated that genetic variants in the DRD2 gene might potentially contribute to genetic susceptibility for PTSD and MDD. The utilization of DRD2 genetic variants as risk factors for PTSD and MDD requires further validation by large well-designed case-control studies.

Effects of trauma-focused rumination among trauma-exposed individuals with and without posttraumatic stress disorder: An experiment.

Rumination, or thinking repetitively about one's distress, is a risk factor for posttraumatic stress disorder (PTSD). Current theories suggest that rumination contributes to PTSD symptoms directly, by increasing negative reactions to trauma cues (i.e., symptom exacerbation), or represents a form of cognitive avoidance, if verbal ruminations are less distressing than trauma imagery. The goal of this study was to test the symptom exacerbation and cognitive avoidance accounts of trauma-focused rumination. We recruited 135 trauma-exposed participants (n = 60 diagnosed with PTSD) and randomly assigned them to ruminate about their trauma, distract themselves, or engage in trauma imagery. For individuals with and without PTSD, rumination led to larger increases in subjective distress (i.e., negative affect, fear, sadness, subjective arousal, valence) than distraction, ηp 2 s = .04-.13, but there were no differences between rumination and imagery ηp 2 s = .001-.02. We found no evidence that rumination or imagery elicited physiological arousal, ds = 0.01-0.19, but did find that distraction reduced general physiological arousal, as measured by heart rate, relative to baseline, d = 0.84, which may be due to increases in parasympathetic nervous system activity (i.e., respiratory sinus arrhythmia), d = 0.33. These findings offer no support for the avoidant function of rumination in PTSD. Instead, the findings were consistent with symptom exacerbation, indicating that rumination leads directly to emotional reactivity to trauma reminders and may be a fruitful target in PTSD intervention.

Prevalence and associated factors of post-traumatic stress disorder in parents whose infants have single ventricle heart disease.

Post-traumatic stress disorder occurs in parents of infants with CHD, contributing to psychological distress with detrimental effects on family functioning and well-being. We sought to determine the prevalence and factors associated with post-traumatic stress disorder symptoms in parents whose infants underwent staged palliation for single ventricle heart disease. A large longitudinal multi-centre cohort study evaluated 215 mothers and fathers for symptoms of post-traumatic stress disorder at three timepoints, including post-Norwood, post-Stage II, and a final study timepoint when the child reached approximately 16 months of age, using the self-report questionnaire Impact of Event Scale - Revised. The prevalence of probable post-traumatic stress disorder post-Norwood surgery was 50% of mothers and 39% of fathers, decreasing to 27% of mothers and 24% of fathers by final follow-up. Intrusive symptoms such as flashbacks and nightmares and hyperarousal symptoms such as poor concentration, irritability, and sudden physical symptoms of racing heart and difficulty breathing were particularly elevated in parents. Higher levels of anxiety, reduced coping, and decreased satisfaction with parenting were significantly associated with symptoms of post-traumatic stress disorder in parents. Demographic and clinical variables such as parent education, pre-natal diagnosis, medical complications, and length of hospital stay(s) were not significantly associated with symptoms of post-traumatic stress disorder. Parents whose infants underwent staged palliation for single ventricle heart disease often reported symptoms of post-traumatic stress disorder. Symptoms persisted over time and routine screening might help identify parents at-risk and prompt referral to appropriate supports.

Identification of underlying factors of post-traumatic stress disorder in Kermanshah earthquake survivors

Background and purpose: Earthquake is one of the most destructive and devastating natural events. The present study was conducted with the aim of identifying the underlying factors of post-traumatic stress disorder in earthquake survivors. Methods: The current research is practical in terms of its purpose and in terms of method, it is a part of sequential exploratory combined methods (qualitative-quantitative). The current research population includes all women and men who survived the Kermanshah earthquake in the cities of Salas Babajani and Sarpul Zahab located in Kermanshah province, who were exposed to the earthquake. The sample of this research was 378 earthquake victims of Sarpol Zahab and Salas Babajani cities located in Kermanshah province. The questionnaire of the underlying factors of post-traumatic stress disorder is made by the researcher and has 56 questions. The method of analysis of the present study was confirmatory factor analysis using SPSS software, version 24. Results: The results showed that the underlying factors of post-traumatic stress disorder in earthquake survivors included economic, environmental, psychological, family, social and cultural factors. The findings have shown that all factors of the questionnaire are positively correlated with each other at a significance level of 0.01. Based on this, it can be said that the factors of the questionnaire of the underlying factors of suffering from post-traumatic stress disorder had an acceptable internal correlation. Conclusion: It can be concluded that these factors can be used to predict people who will get this disease in the future.

Interplay of Post-Traumatic Stress Disorder, General Anxiety Disorder and Resilience among Earthquake Survivors in Zinda Jan District of Herat Province

‌Background: Frequent earthquakes that hit Herat province in October 2023 resulted in considerable loss of lives and massive property damage. They caused massive physical and psychosocial injuries; while physical injuries could be treated by healthcare professionals, psychological injuries could be neglected. This study aimed to assess the prevalence and associated factors of post-traumatic stress disorder (PTSD) and general anxiety disorder (GAD); and their association with resilience among earthquake survivors in Zinda Jan district. Materials and Methods: This community-based cross-sectional study was conducted during October and November 2023, among 418 cases -including 206 (49.3%) males and 212 (50.7%) females- with a mean age of 40.16±14.17 years. Sociodemographic data was collected via a structured questionnaire, data on PTSD was collected using the PTSD Checklist for DSM-5 (PCL-5), and data on GAD was collected via the Dari-version of GAD-7 questionnaire. Findings: GAD was detected in all (100%) participants, of whom 6 (1.4%), 29 (6.9%), and 383 (91.6%) had mild, moderate, and severe anxiety, respectively. Furthermore, 153 (36.6%), 134 (32.1%) and 131 (31.3%) participants suffered from mild, moderate and severe PTSD. As per resilience, 153 (36.6%) had low resilience, 142 (34.0%) had moderate resilience, and 123 (29.4%) had high resilience. There was a significant association between resilience and PTSD (p=0.011), but no significant association was observed between resilience and GAD (p=0.515). GAD was significantly associated with gender, marital status, and participants’ access to mental health. A significant association was found between PTSD and participants’ occupation, nutrition status, and access to mental health. Conclusion: The interplay between post-traumatic stress disorder, generalized anxiety disorder and resilience among earthquake survivors in the Zinda Jan district is a complex and multifaceted issue that demands further research and intervention. While the experiences of an earthquake can lead to the development of PTSD and GAD, resilience plays a crucial role in helping individuals overcome these challenges and rebuild their lives. A comprehensive understanding of this interplay can inform the development of effective interventions and prevention programs to support earthquake survivors and promote their overall well-being.

A Prevalence Study of Post-Traumatic Stress Disorder and Its Sociobiological Determinants During Second Wave of COVID-19 Pandemic Among General Population of National Capital Territory of Delhi

Introduction: Nationwide lockdown during COVID-19 pandemic, rapid transmission of SARS-CoV-2 and more intense second wave of pandemic in terms of high caseload, reduced essential supplies and scarcity of beds, and unpredictable mortality had a huge impact on mental health of general population. Objectives: This study aimed to estimate the prevalence and determine the factors of Post-Traumatic Stress Disorder (PTSD) among the general population of India during the second wave of pandemic. Methodology: An online survey was conducted to estimate the prevalence and assess the factors responsible for PTSD among 614 participants who were above 18 years of age. The prevalence of PTSD was measured using PTSD checklist for Diagnostic and Statistical Manual of Mental Disorder-5 (DSM-5). Results: In the present study, there were a total of 614 participants and the mean age of the participants was 23.64 years. More than half of the participants were female and majority of them were unmarried (76.7%). The prevalence of PTSD was 30.62%. A significant association was observed between occupation and PTSD prevalence. Also, COVID-19 illness, COVID-19 infection among the family members, work outside the home, hospital admissions, difficulty in acquiring the required medication were significantly associated with PTSD. Conclusion: COVID-19 pandemic and nationwide lockdown led to increased prevalence of psychological effects like PTSD. This highlights the importance of focusing on mental health during the pandemic.

Post-traumatic stress disorder and related psychopathology in parents of children with epilepsy

Mental difficulties and psychiatric illnesses are common in families of children with epilepsy. The aim of this study is to investigate the prevalence and possible risk factors of post-traumatic stress disorder, depression, and anxiety in a sample of parents of children with epilepsy. Parents of children with epilepsy who presented to Turgut Ozal Medical Center Pediatric Neurology Outpatient Treatment Unit between January and March 2023 were invited to this cross-sectional study. Participants filled out a questionnaire examining demographic variables. Depression and anxiety levels were evaluated with the Hospital Anxiety and Depression Scale (HAD-S), and post-traumatic stress levels were evaluated with the Post-Traumatic Stress Disorder short scale (PTSD-short scale). A total of 89 parents, including 47 mothers, and 42 fathers, participated in the study. Of the study participants, 10.11% were at risk for depression and 3.4% for anxiety disorder. 6.7% had PTSD. There was a positive correlation between HAD-S subscale scores and PTSD-short scale scores. According to the linear regression model, PTSD was negatively correlated with having a job and education level, and positively correlated with anxiety and depression. Anxiety and depression were only associated with PTSD. Parents of epileptic children are at risk for PTSD, depression, and anxiety. Clinicians need to identify at-risk parents at an early stage and develop specific assist-oriented intervention programs to provide systematic support.

Correlates of Skin Conductance Reactivity to Stroke-Related Trauma Reminders During Hospitalization for Stroke

Objective Although several risk factors for stroke-induced posttraumatic stress disorder (PTSD) have been identified, objective risk measures that can be detected in the acute aftermath of these events are needed. This study is the first to collect an objective measure of psychophysiological arousal—skin conductance (SC) reactivity to a trauma interview—in patients after stroke or transient ischemic attack (TIA) and investigate correlates of SC reactivity. Methods Mobile SC measurement during a resting baseline and standardized trauma interview was performed in-hospital in 98 individuals following stroke/TIA. We examined associations between several stroke-induced PTSD risk factors (sociodemographic, psychosocial, and medical characteristics) and SC reactivity to a trauma interview involving a free-response recalling of the stroke/TIA event. Results Of the sociodemographic, psychosocial, medical characteristics examined as correlates to SC reactivity to recalling the stroke/TIA event, 2 factors reflecting aspects of prior and in-hospital experience were significantly associated with this indicator of sympathetic nervous system activation. A greater cumulative trauma burden was significantly associated with greater SC reactivity (r = .23, P = .04). Additionally, individuals administered benzodiazepines in-hospital had significantly greater SC reactivity to recalling the stroke/TIA event (M = 1.51, SD = 1.52) than those who were not (M = 0.76, SD = 1.16; P = .01). Greater cumulative trauma burden remained significantly associated with greater SC reactivity when adjusting for age and in-hospital benzodiazepine administration (β=0.22, P = .04). Conclusion This study demonstrated that SC reactivity was related to both behavioral and psychological risk factors for PTSD after a stroke/TIA event. Additionally, we demonstrated the feasibility of a low-cost, mobile measurement of SC that can be conducted in-hospital in a novel patient population: individuals with a medical trauma. With this measure, we were able to identify those individuals with the greatest trauma-related sympathetic nervous system reactivity in the days following a medical trauma. Future research is needed to determine whether SC reactivity may be leveraged in the development of brief, noninvasive screening measures for enhancing PTSD risk prediction.

Post-Traumatic Stress Disorder among Emergency Medical Technicians and its Relationship with Occupational Stress and Depression: Post-Corona Screening, Zanjan, 2022.

Emergency medical technicians (EMTs) are at risk of developing post-traumatic stress disorder (PTSD) as a result of seeing painful events involving suspected COVID-19 patients and being concerned about potentially infecting themselves and their families. Therefore, screening for these disorders is essential in the post-Corona era. This study aimed to investigate the prevalence of PTSD among EMTs and its relationship with occupational stress and depression when dealing with patients with suspected COVID-19. This cross-sectional study was conducted on EMTs at Zanjan University of Medical Sciences using a convenience sampling method. Data were collected using a demographic information questionnaire, PTSD checklist, occupational stress questionnaire, and the Goldberg depression scale. The data were analyzed using SPSS software. Statistical tests such as Pearson correlation and logistic regression analysis were used to evaluate the data. 205 EMTs participated in this cross-sectional study. The mean and standard deviation of PTSD was 37.13±12.93 (17-85), and according to the cut-off (45), the prevalence of PTSD was 30.7%. There was a direct and significant association between the total PTSD and depression scores (r=0.435, p=0.001). Some occupational stress domains, such as demand (r=0.306, p=0.001), colleague support (r=0.149, p=0.033), and communication (r=0.293, p=0.001) had a significant association with PTSD. The domains of sadness in depression (OR=1.074, p=0.027) and demands in occupational stress (OR=1.872, p=0.029) were the most important predictors of PTSD. Among demographic variables, employment status was the most important protective factor for PTSD (OR=0.378, p=0.038). PTSD affected one-third of EMTs, and it had a significant relationship with various dimensions of depression and occupational stress. Due to the chronic nature of these diseases, policymakers are advised to prioritize psychological screening of EMTs as part of the post-Corona policy.

Anxiety, depression and post-traumatic stress disorder and related factors among Chinese population during the COVID-19 pandemic: A cross-sectional study.

The sudden outbreak of coronavirus disease 2019 (COVID-19) has deep and wide negative mental impacts on the public, and studies on the impact of COVID-19 on social and mental well-being are necessary. This study aimed to evaluate mental distress, including anxiety, depression, and post-traumatic stress disorder (PTSD), and its related risk factors in Chinese adults in the early stages of the COVID-19 pandemic. This study used a large-scale cross-sectional design. A total of 2067 adult participants completed the online survey via REDcap from 1st to 15th of March 2020 during the COVID-19 outbreak in China. Anxiety, depression, PTSD, and related risk factors, including self-efficacy, coping style, and social support, were measured using valid and reliable instruments. The data were analyzed using multiple linear regression. We found that 201 (9.7%) participants reported moderate-to-severe anxiety, 669 (33.8%) reported depression, and 368 (17.8%) reported symptoms of PTSD. Self-efficacy, coping style, and social support significantly affected anxiety, depression, and PTSD symptoms. Participants' sociodemographic characteristics, COVID-19 pandemic-related factors, low self-efficacy, low social support, and negative coping were predictors of mental distress during the COVID-19 pandemic. Our study will help healthcare professionals carry out early predictions and identification of high-risk groups and provide appropriate interventions to target groups during public health emergencies that plague the world.

Measuring post-traumatic stress disorder and complex post-traumatic stress disorder using the International Trauma Questionnaire: results from a Hungarian clinical and non-clinical sample

ABSTRACT Background: The 11th revision of the International Classification of Diseases (ICD-11) simplified the description of post-traumatic stress disorder (PTSD) and also introduced a new trauma-related diagnosis called complex post-traumatic stress disorder (CPTSD). CPTSD is linked to earlier, prolonged interpersonal trauma, and is characterized by a broader range of symptoms, in addition to the core PTSD symptoms. The International Trauma Questionnaire (ITQ) has been developed to assess the new diagnostic criteria. Objectives: The primary aim of our study was to test the factor structure of the ITQ in a clinical and a non-clinical Hungarian sample. We also examined whether the degree of traumatization or the type of trauma experienced was associated with meeting the criteria for PTSD or CPTSD, or with the severity of PTSD or disturbances in self-organization (DSO) symptoms, in both samples. Method: A trauma-exposed heterogeneous clinical sample (N = 176) and a non-clinical sample (N = 229) filled out the ITQ and a modified version of the Life Events Checklist (LEC-5). The factor structure of the ITQ was tested by examining the model fit of seven competing confirmatory factor analysis models. Results: A two-factor second-order model with a second-order PTSD factor (measured by three first-order factors) and a DSO factor (measured directly by six symptoms) had the best fit to the data in both samples if an error correlation was allowed between negative self-concept items. Those in the clinical group who reported more interpersonal and childhood trauma experienced more PTSD and DSO symptoms. Also, there were significant, positive, and weak associations between the total number of different traumas and PTSD and DSO factor scores in both samples. Conclusion: ITQ was found to be a reliable tool to differentiate between PTSD and CPTSD, two related but distinct constructs in a clinical and a non-clinical trauma-exposed sample in Hungary.

Prevalence and Risk Factors of Post-Traumatic Stress Disorder in a North Cyprus Household Adult Cross-Sectional Study

Prevalence and Risk Factors of Post-Traumatic Stress Disorder in a North Cyprus Household Adult Cross-Sectional Study

Impact of the Las Vegas Mass Shooting Event on the Graduate Medical Education Mission: Can There Be Growth from Tragedy?

Our aim was to determine the psychological and educational impact of the 2017 Las Vegas mass shooting on the graduate medical education (GME) mission within two cohorts of resident physicians and attending faculty at two nearby academic trauma centers. A cross-sectional survey assessed 55 resident physicians and attending faculty involved in the acute care of the patients from the mass shooting. We measured the psychological impact of the event, post-traumatic growth, team cohesion, social support, and known risk factors for post-traumatic stress disorder (PTSD). Additionally, we assessed the impact of the event on GME-specific tasks. Attending faculty and physicians in training in GME residencies evaluated over 300 penetrating trauma patients in less than 24 hours, and approximately 1 in 3 physicians had a patient die under their care. Despite this potential for psychological trauma, the majority of clinicians reported minimal distress and minimal impact on GME activities. However, 1 in 10 physicians screened positive for possible PTSD. Paradoxically, the minority of physicians who sought psychological counseling after the event (20%) were not those who reported the highest levels of distress. Residents generally assessed the event as having an overall negative impact on their educational goals, while attendings reported a positive impact. Psychological impact correlated inversely with social support and the amount of prior education relating to mass casualty incidents (MCI) but correlated directly with the degree of stress prior to the event. Despite the substantial level of exposure, most resident physicians did not report significant psychological trauma or an impact on their GME mission. Some reported post-traumatic growth. However, a minority reported a significant negative impact; institutions should consider broad screening efforts to detect and assist these individuals after a MCI. Social support, stress reduction, and education on MCIs may buffer the effects of future psychologically traumatic events on physicians in training.

Critical Incidents Scale for Ambulance Work - Denmark (CISAW-D): the development of a screening tool for work exposure to critical events in operative ambulance personnel.

Critical incidents in ambulance work are not easily compared to other risk occupations. Understanding types of incidents that can be considered critical in operational ambulance work is important to prevent work-related post-traumatic stress (PTS). This study aimed to develop a scale of critical incidents in ambulance work and assess its predictive validity in relation to the severity of PTS symptoms. A total of 1092 open-ended descriptions from Danish ambulance personnel were content analysed to develop a categorical scale that identifies types of events perceived as critical to operative ambulance personnel. Multiple regression was used to assess whether the scale predicted PTS symptoms and to assess the cumulative effect of exposure to these events. The study found that the 1092 descriptions of critical events could be condensed into 28 categories of critical events. These ranged from life-threatening situations and deaths, to more daily events such as handling strong emotional reactions from patients' relatives and working with terminally ill children. The frequency of events significantly predicted the severity of PTS symptoms with low to moderate effect (std beta = 0.2, t(375) = 3.7, p < .001), even when adjusting for known risk factors for post-traumatic stress disorder. This study showed that critical events in ambulance work included events that are not normally considered traumatic, and indicated that understanding the cumulative effect of these events is important when trying to prevent traumatic sequalae in ambulance personnel. The study highlighted the importance of increased focus on non-traumatic incidents that have an ongoing impact on paramedics' mental health and well-being. The Critical Incidents Scale for Ambulance Work - Denmark (CISAW-D) is a promising tool for systematic screening for exposure to critical events in ambulance work.