Higher Posttraumatic Stress Disorder Scores Research Articles

The relationship between earthquake-induced post-traumatic stress disorder and breastfeeding attitude and behavior

BackgroundThis study aimed to investigate the prevalence and severity of post-traumatic stress disorder (PTSD) and analyze the relationship between PTSD and breastfeeding attitudes and behaviors among breastfeeding mothers and women with children aged 0–24 months, all of whom had experienced the earthquake.MethodsIn this cross-sectional survey, a face-to-face questionnaire was administered to 173 earthquake survivors in Adıyaman, Turkey, during June and July 2023. The PTSD Checklist-Civilian scale was used to assess the presence of PTSD, while the Breastfeeding Attitudes of the Evaluation Scale (BAES) was employed to evaluate breastfeeding behaviors in mothers.ResultsSignificantly higher PTSD scores (47.6 ± 17.4) were found among women staying in tents, while lower scores (37.0 ± 16.4) were observed in those who continued breastfeeding. 78.6% of women reported decreased breast milk because of the earthquake. Mothers with reduced milk supply had higher PTSD scores (46.1 ± 17.3). Breastfeeding training was associated with higher BAES scores (106.8 ± 56.8) and lower PTSD scores (32.5 ± 11.0). A significant negative correlation was observed between the PTSD score and BAES (r = -0.742; p < 0.001).ConclusionsThe study demonstrated that breastfeeding may protect mothers against PTSD in the aftermath of earthquakes, emphasizing the importance of breastfeeding education. The higher frequency and severity of PTSD observed among earthquake survivor mothers residing in tents underscores the importance of promptly transitioning to permanent housing after the earthquake.

Relationship between parental stress and post-traumatic stress disorder: The moderating effect of visitation restrictions in paediatric intensive care units during COVID-19.

Visitation restrictions due to COVID-19 kept parents from being with their children who were hospitalized in the PICU and from meeting with professional staff. This study examined the moderating effect of COVID-19-induced visitation restrictions on the relationship between stress and post-traumatic stress disorder in parents of children admitted to the paediatric intensive care unit. We conducted a descriptive, exploratory study involving 93 parents of children hospitalized in the paediatric intensive care unit using the Korean version of the Parental Stressor Scale: Paediatric Intensive Care Unit and the Revised Impact of Events Scale. Descriptive, Pearson's correlation, and logistic regression analyses were used to investigate the data. Self-reported survey questionnaires were provided for parents to complete in a separate area of the outpatient clinic when they visited for follow-up care after their children were discharged from the paediatric intensive care unit. Mothers showed significantly higher post-traumatic stress disorder scores than fathers. The relationship between all the sub-domains of perceived stress and post-traumatic stress disorder was statistically significant. Visitation restrictions because of the COVID-19 pandemic had significant moderating effects on the relationship between perceived parental stress and post-traumatic stress disorder. Moreover, the moderating effects of COVID-19 were exhibited when the two sub-domains-hyperarousal and intrusion-were investigated. Paediatric intensive care unit visitation may be an important intervention for parental post-traumatic stress disorder. Parental visitation should be enabled, and alternative interventions should be developed in situations where visitation is prohibited. It is necessary to develop and apply various and effective alternatives visitation that can prepare hospitals for visiting restrictions during pandemic situations which could emerge in the future.

Genetic variants associated with post-traumatic stress symptoms in patients with gynecologic cancer

ObjectivePatients with cancer experience symptoms of post-traumatic stress disorder (PTSD) more commonly than the general population. The objective of this study was to identify single nucleotide polymorphisms (SNPs) associated with increased risk of post-traumatic stress disorder (PTSD) in patients with gynecologic cancer. MethodsA prospective cohort study recruited 181 gynecologic cancer survivors receiving care at the University of Minnesota between 2017 and 2020 who completed PTSD DSM-V surveys to self-report their symptoms of PTSD and provided saliva samples. DNA samples were genotyped for 11 SNPs in 9 genes involved in dopaminergic, serotonergic, and opioidergic systems previously associated with risk of PTSD in populations without cancer. ResultsMost participants had either ovarian (42.5%) or endometrial (46.4%) cancer; fewer had cervical (7.7%) or vaginal/vulvar (3.3%) cancer. Two SNPS were identified as statistically significantly associated with higher PTSD scores: rs622337 in HTR2A and rs510769 in OPRM1. ConclusionsGenetic variation likely plays a role in development of PTSD. HTR2A is involved in the serotonin pathway, and OPRM1 is involved in the opioid receptor pathway. This information can be used by oncologic providers to identify patients at greater risk of developing PTSD and may facilitate referral to appropriate consultants and resources early in their treatment.

Risk and protective factors affecting the symptom trajectory of posttraumatic stress disorder post-rape

IntroductionThe prevalence of posttraumatic stress disorder (PTSD) in rape survivors is considerably higher than the prevalence in non-sexual trauma survivors. Few studies have investigated risk and protective factors in survivors early-after-rape in a prospective longitudinal design. MethodsIn a sample of 639 rape-exposed women who were assessed within 20 days of rape and over 6 months, baseline data were used to predict PTSD symptom severity scores up to 6 months post-rape. ResultsThe incidence of PTSD at 3 months was 48.5% and the cumulative incidence at 6 months post-rape was 54.8%. Baseline experience of rape stigma (guilt, shame, self-blame, social devaluation and discredit) and depression were significant predictors of PTSD symptom scores over time, in mixed linear regression models. Higher levels of depression and rape stigma were associated with higher PTSD scores. Assault-related factors were not associated with PTSD scores. LimitationsWe could not measure PTSD symptom trajectories in all rape survivors, some of who may be at greater risk for PTSD e.g. non-disclosing rape survivors, those who declined participation and those who were extremely distressed at the time of recruitment. ConclusionAddressing internalised and externalised stigma and resultant mental health effects on women who present to rape clinics may reduce the long-term adverse effects of rape on mental health outcomes, such as PTSD. Rape survivors who present with high levels of depression soon after a rape should be carefully monitored and appropriately treated in order to reduce PTSD severity.

Prevalence of Anxiety, Depression, and Post-Traumatic Stress Disorder Among Amputees Attending Jaipur Foot Trust Artificial Limb Centre in Kenya

Background: Amputees have been noted to present various psychiatric disorders including anxiety, body image disturbances, depression, and Post-Traumatic Stress Disorder (PTSD). However, there is limited data available on the prevalence of anxiety, depression, and PTSD among amputees in Kenya despite the high incidences of amputations in Kenyan hospitals. This study aimed at finding out the prevalence of anxiety, depression, and post-traumatic stress disorder among amputees attending the Jaipur Foot Trust Centre in Kenya. Method: This study took a cross-sectional descriptive study design. One hundred and forty-one patients attending the Jaipur Foot Trust were recruited to participate in the study after giving informed consent using a non-probability purposive sampling method. A socio-demographic questionnaire was used to collect socio-demographic characteristics. The Patient Health Questionnaire (PHQ-9) was used to assess the patient's depression. The Generalized Anxiety Disorder (GAD-7) scale was used to assess the patient's anxiety level and The Impact of Event Scale (IES-R) was used to assess the severity of post-traumatic stress disorder (PTSD). Data analysis was done using Statistical Package for Social Science (SPSS) version 23. Results: Findings from this study showed high rates of psychiatric morbidity where two-thirds of the patients reported PTSD (65%) with more than three-quarters of patients being diagnosed with depression (89.4%) and anxiety (91.5%). Also, there was a significant correlation between depression, anxiety, and PTSD, such that participants who had higher scores on anxiety and depression had significantly higher PTSD scores. Conclusion: Anxiety, Depression, and PTSD are very common psychological reactions in patients who have undergone amputation. The researchers expected that some of the sociodemographic factors and some amputation-related characteristics would have a relation with psychiatric comorbidity. However, the findings of this study did not show any such relationship except the relation between anxiety, depression, and PTSD. Early psychological assessment and interventions after amputations will help alleviate psychological distress.

Post-Traumatic Stress Disorder and Associated Factors among Caregivers of Patients with COVID-19 in Saudi Arabia: A Cross-sectional Study

Background: One of psychological disorders caused by catastrophic life events or severe medical problems is the incidence of post-traumatic stress disorder among people. Different sociodemographic factors have been associated with the development of post-traumatic stress disorder (PTSD). Such research is lacking with COVID-19 especially in the Saudi context.&#x0D; Aim: The purpose of this study was to determine factors associated with PTSD during the outbreak of COVID-19.&#x0D; Materials and Methods: This cross-sectional study was conducted on a convenience sample of 92 Saudi citizens, living in Saudi Arabia, and had at least one relative who had been diagnosed with COVID-19. Data were collected using the impact of event scale (IES-R). SPSS was used to run a multiple linear regression analysis.&#x0D; Results: The results revealed that participants suffered from a partial PTSD. The regression analysis showed a significant relationship between participants’ characteristics and PTSD. The model explained 13.9% of the variance of PTSD (F [5, 77] = 2.49, R2 =.139, p&lt; .05). Two predictors of gender (p&lt;.01) and level of education (p&lt;.05) were statistically significant to the prediction. Male participants had higher PTSD scores than female participants (beta = -9.19, t = -2.73, p&lt; .01). Also, those caregivers with low level of education had higher PTSD levels (beta = 3.279, t = 2.30, p &lt;.05).&#x0D; Conclusion: The current study demonstrated a strong association between participants’ demographic characteristics (namely gender and level of education) and PTSD. A lack of information and the evolution of the COVID-19 outbreak may be important factors in increasing people’s levels of PTSD. Therefore, future research aiming to find appropriate solutions to such issues is recommended.

Hate and harassment in academia: the rising concern of the online environment

Hostile online communication is a global concern. Academic research and teaching staff are among those professionals who routinely give public comments and are thus vulnerable to online attacks. This social psychological and criminological study investigated online harassment victimization among university researchers and teachers. Survey participants (N = 2,492) were university research and teaching staff members from five major universities in Finland. Victimization was assessed with a 20-item inventory. The study included a wide range of both background and general measures on well-being at work. Participants also took part in an online experiment involving a death threat targeting a colleague. Results showed that 30% of the participants reported being victims of online harassment during the prior 6 months. Victims were more often senior staff members, minority group members, and from the social sciences and humanities. Those active in traditional or social media were much more likely to be targeted. Victims reported higher psychological distress, lower generalized trust, and lower perceived social support at work than non-victims. Individuals who were targeted by a colleague from their work community reported higher post-traumatic stress disorder scores and a higher impact of perceived online harassment on their work compared to other victims. In the experimental part of the study, participants reported more anxiety when a close colleague received a death threat. Participants also recommended more countermeasures to a close colleague than to an unknown person from the same research field. Results indicate that online harassment compromises well-being at work in academia. There is an urgent need to find ways of preventing online harassment, both in workplaces and in society at large.

Relationship of rumination and self-compassion to posttraumatic stress symptoms among Veterans

ABSTRACT Past research demonstrates interrelationships amongst rumination, self-compassion, and posttraumatic stress disorder (PTSD) symptoms. However, little research has considered rumination and self-compassion together in relation to PTSD in clinical populations. In this cross-sectional study, we examined the unique effect of self-compassion on PTSD beyond the effect of rumination. Secondarily, we examined if rumination mediates the effect of self-compassion on PTSD. Participants included 52 US military Veterans (73.1% male) enrolled in a community support program for PTSD who completed self-report measures of study variables at one time point. Hierarchical regression results showed rumination was related to higher PTSD scores (f2 = .12; small ES) in step one, and the addition of self-compassion in step two was related to lower PTSD scores (f2 = .10; small ES) and explained a unique 9% of the variance. In contrast to previous research, results showed self-compassion mediated the relationship between rumination and PTSD, with a significant indirect effect (ab) of .20 (95% confidence interval [CI] = .028 to .457). Findings suggest the explanatory value of self-compassion for PTSD after accounting for rumination and may also reflect a process where rumination about behaviors one regrets gives rise to uncompassionate responding, which then contributes to greater PTSD.

Traumatic Stress of Frontline Workers in Culling Livestock Animals in South Korea.

Simple SummaryThough culling is an effective measure for controlling animal diseases, it could have detrimental effects on mental health among frontline workers, and poses ethical problems concerning the treatment of animals. This research investigates the stress from culling and its effect on workers’ mental health. The data from an online survey of frontline workers showed that the working condition was very hard on them, causing adverse effects such as depression and post-traumatic stress disorder (PTSD) symptoms. Three-fourths of the respondents were identified as being from a high-risk group in terms of mental health. Further analysis revealed sequential causation, where workers with greater pro-animal attitudes felt more hardship in performing culling jobs, which triggered stronger negative emotions and resulted in higher PTSD scores. A regulation to implement processes for reducing the impacts of culling and ex-post measures for the workers is required to prevent the negative effects of culling on workers.The last decade brought several devastating outbreaks of foot and mouth disease and avian influenza in South Korea, which had been handled through preventive culling, despite the controversy surrounding its efficiency and ethical considerations. Notably, the lack of regulations on culling processes has exposed the workers to extremely harsh working conditions. This study investigates the effect of culling jobs on the mental health of the frontline workers, based on 200 samples collected through a web-based survey conducted on participants with experience of culling tasks. Culling was found to have a powerful negative effect on the workers’ mental health, including high depression rates. Of those surveyed, 83.7% answered that the working conditions were intense, and 74.5% showed scores above the cutoff point for post-traumatic stress disorder (PTSD). A regression analysis revealed that individual’s attitudes toward animals mediated the effect of culling experience on PTSD symptoms. However, mental health care for the workers has been insufficient: 70.2% of the respondents were willing to get mental treatment to deal with the distress they underwent from culling. We conclude that engagement in culling has a detrimental effect on the workers’ mental health, and that they should be provided with systematic mental health care.

Symptoms of Posttraumatic Stress Disorder and Associated Risk Factors in Patients With Lung Cancer: A Longitudinal Observational Study.

Purpose. This study aimed to measure symptoms of posttraumatic stress disorder (PTSD) in Chinese patients following a new diagnosis of lung cancer. Secondary aims were to explore factors at diagnosis that may predict PTSD symptoms at 6 months. Methods. This was a prospective longitudinal observational study that included 93 patients with newly diagnosed lung cancer. PTSD symptomology was assessed using the PTSD Checklist Civilian Version (PCL-C) and health-related quality of life (HRQoL) was assessed with the European Organisation for the Research and Treatment of Cancer questionnaire. Measures were completed at diagnosis and 6 months. Results. No patient had PTSD at baseline or 6 months as measured by a score of ⩾50 in the PCL-C. However, at diagnosis, 44% of patients had “mild” symptoms of PTSD. At 6 months, 64% of patients had “mild” and 8% had “moderate” PTSD symptoms. PTSD symptom scores significantly worsened over 6 months (mean difference [95% CI] = 7.2 [5.4 to 9.0]). Six months after diagnosis, higher PTSD scores were seen in people who at diagnosis were younger (P = .003), had a lower smoking pack history (P = .012), displayed less sedentary behavior (P < .005), or initially had worse cancer symptoms, including fatigue (P = .001) and poorer HRQoL (P = .004). Conclusions. Mild PTSD symptoms are common in patients with lung cancer 6 months after treatment; however, a full diagnosis of PTSD is uncommon. Screening for PTSD symptoms may be considered for at-risk patients with newly diagnosed lung cancer.

Postpartum psychological distress after emergency team response during childbirth

Purpose: To evaluate the feasibility and acceptability of a protocol determining the relationship between emergency team response (ETR) during childbirth and acute stress disorder (ASD) and post-traumatic stress disorder (PTSD) symptoms.Methods: In a prospective, observational, cohort design, women experiencing ETR during childbirth were approached and recruited on postpartum day-1 and followed for six weeks. Demographics, obstetric and birth characteristics, ASD scores and PTSD scores (by Impact of Events Scale, IES and PCL-civilian) were recorded. Recruitment and retention rates were recorded, and scores were compared to women who did not experience ETR.Results: Three hundred sixty-nine were approached and 249 were enrolled (67.5% recruitment rate). One hundred twenty-five completed all procedures (50.2% retention). Twenty experienced ETR (3.5% event rate), 12 enrolled (60.0% recruitment rate) and 8 completed the study (66.7% retention). The ETR group had higher PCL and IES scores (PCL: ETR median 12, non-ETR median 2, p = .08; IES: ETR median 22.5, non-ETR median 20, p = .08). ASD scores were similar between groups.Conclusions: Methodology investigating the link between ETR and postpartum psychological distress is feasible and acceptable. A relationship between ETR and PTSD symptoms appears to exist, with ETR being associated with higher PTSD scores compared to non-ETR childbirths. Methods that incorporate awareness of the unique concerns of vulnerable populations are needed.

Symptoms of posttraumatic stress disorder among hospitalized patients with cancer.

Patients with cancer experience many stressors placing them at risk for posttraumatic stress disorder (PTSD) symptoms, yet little is known about factors associated with PTSD symptoms in this population. This study explored relationships among patients' PTSD symptoms, physical and psychological symptom burden, and risk for hospital readmissions. We prospectively enrolled patients with cancer admitted for an unplanned hospitalization from August 2015-April 2017. Upon admission, we assessed patients' PTSD symptoms (Primary Care PTSD Screen), as well as physical (Edmonton Symptom Assessment System [ESAS]) and psychological (Patient Health Questionnaire 4 [PHQ-4]) symptoms. We examined associations between PTSD symptoms and patients' physical and psychological symptom burden using linear regression. We evaluated relationships between PTSD symptoms and unplanned hospital readmissions within 90-days using Cox regression. We enrolled 954 of 1,087 (87.8%) patients approached, and 127 (13.3%) screened positive for PTSD symptoms. The 90-day hospital readmission rate was 38.9%. Younger age, female sex, greater comorbidities, and genitourinary cancer type were associated with higher PTSD scores. Patients' PTSD symptoms were associated with physical symptoms (ESAS physical: B = 3.41; P < .001), the total symptom burden (ESAS total: B = 5.97; P < .001), depression (PHQ-4 depression: B = 0.67; P < .001), and anxiety symptoms (PHQ-4 anxiety: B = 0.71; P < .001). Patients' PTSD symptoms were associated with a lower risk of hospital readmissions (hazard ratio, 0.81; P = .001). A high proportion of hospitalized patients with cancer experience PTSD symptoms, which are associated with a greater physical and psychological symptom burden and a lower risk of hospital readmissions. Interventions to address patients' PTSD symptoms are needed and should account for their physical and psychological symptom burden. Cancer 2018. © 2018 American Cancer Society.

133. Relationships between hair cortisol and marital status in female veterans

Hair cortisol is thought to represent long-term activation of the HPA axis. An increasing body of research has used hair cortisol in research on disorders such as post-traumatic stress disorder (PTSD), generalized anxiety disorder, and depression, as well as in individuals who are unemployed or working night shift. This research examined a sample of 52 female veterans, collecting demographic information such as marital and employment status, as well as psychosocial factors such as PTSD, depression, anxiety, and pain. The mean hair cortisol level was 27.46 pg/mg. Results include a significantly lower hair cortisol in single women veterans compared to veterans who were married currently or at some point in time (t = −2.734, p = .009). In addition, married women had lower plasma IFN-gamma levels (t = 2.61 p = .013). Finally, single women were shown to drink less alcohol than married veterans (t = 2.01, p = .05). Current analysis suggests a trend in lower hair cortisol in women with higher PTSD scores. In the military, there is a high incidence of divorce and marriage difficulties. With these difficulties there may be an increase in chronic stress and alterations in the HPA axis and immunity.

Does the Repressor Coping Style Predict Lower Posttraumatic Stress Symptoms?

We tested whether a continuous measure of repressor coping style predicted lower posttraumatic stress disorder (PTSD) symptoms in 122 health care professionals serving in Operation Iraqi Freedom. Zero-order correlational analyses indicated that predeployment repressor coping scores negatively predicted postdeployment PTSD symptoms, r(s) = -0.29, p = 0.001, whereas predeployment Connor-Davidson Resilience Scale (CD-RISC) scores did not predict postdeployment PTSD symptoms, r(s) = -0.13, p = 0.14. However, predeployment trait anxiety was chiefly responsible for the association between repressor coping and PTSD symptom severity, r(s) = 0.38, p = 0.001. Four percent of the subjects qualified for a probable PTSD diagnosis. Although service members with relatively higher PTSD scores had lower repressor coping scores than did the other subjects, their level of predeployment anxiety was chiefly responsible for this relationship. Knowing someone's predeployment level of trait anxiety permits better prediction of PTSD symptoms among trauma-exposed service members than does knowing his or her level of repressive coping.

False memory for trauma-related Deese–Roediger–McDermott lists in adolescents and adults with histories of child sexual abuse

The purpose of the present research was to examine Deese-Roediger-McDermott false memory for trauma-related and nontrauma-related lists in adolescents and adults with and without documented histories of child sexual abuse (CSA). Individual differences in psychopathology and adult attachment were also explored. Participants were administered free recall and recognition tests after hearing CSA, negative, neutral, and positive Deese-Roediger-McDermott lists. In free recall, CSA and negative lists produced the most false memory. In sharp contrast, for recognition, CSA lists enjoyed the highest d' scores. CSA-group adolescents who evinced greater posttraumatic stress disorder (PTSD) symptoms had higher rates of false memory compared to (a) non-CSA group adolescents with higher PTSD symptom scores (free recall), and (b) CSA-group adolescents with lower PTSD symptom scores (recognition). Regression analyses revealed that individuals with higher PTSD scores and greater fearful-avoidant attachment tendencies showed less proficient memory monitoring for CSA lists. Implications for trauma and memory development and for translational research are discussed.

PTSD and depression in refugee children

This paper describes the effect of pre-migration and post-migration experiences on the mental health of a sample of 40 refugee children aged 8-16 who lived in London with at least one parent or a refugee relative. Children's post-traumatic stress disorder (PTSD) and depression symptoms were assessed with standardised self-report measures (Impact of Event Scale and Depression Self-Rating Scale for Children, respectively). Information regarding past and present experiences were gathered during an interview with parents. There was a significant correlation between the number of pre-migration traumas experienced by the families and the children's PTSD scores. There was also a significant correlation between the families' number of post-migration stresses and children's depression scores. Higher PTSD scores were significantly associated with the pre-migration experience of violent death of family members and the post-migration experience of an insecure asylum status. Higher depression scores were significantly associated with insecure asylum status and severe financial difficulties. The clinical implications of these findings are discussed.

War-related trauma and symptoms of posttraumatic stress disorder among adult Kosovar refugees.

Since 1999, almost 16,000 Kosovar refugees have entered the United States. Few studies have investigated trauma and symptoms of posttraumatic stress disorder (PTSD) in this population. We conducted a caseworker-assisted survey of 129 Kosovar refugees (aged 18 to 79 years, 55% male). Of these individuals, 78 (60.5%) showed the likely presence of PTSD. The mean number of war-related traumatic events reported was 15 (SD = 4.5). Higher PTSD scores were associated with more traumatic events and female gender.