History Of Psychological Trauma Research Articles

COVID-related psychological distress fully mediates the association from social impact to sleep disturbance among patients with chronic schizophrenia

The aims of the current study were to identify factors associated with sleep disturbance and Coronavirus disease-19 related psychological distress (CPD), and to develop a conceptual model to verify the mediating effect of CPD on the association between social impact and sleep disturbance. This study recruited patients with schizophrenia. Factors associated with the level of sleep disturbance and CPD were identified using univariate linear regression, and further selected into a stepwise multivariate linear regression model. Using structural equation modeling, a mediation model was developed to test the mediating effect of CPD on the association between social impact and sleep disturbance. After estimating with the stepwise and bootstrap regression, higher levels of CPD were associated with higher levels of social anxiety and subjects without a regular diet. Sleep disturbance was associated with a higher level of social anxiety, a history of psychological trauma, chronic disease, and those who did not smoke. The final model confirmed the mediating effects of CPD; whereas, the direct effect from social impact to sleep disturbance did not reach statistical significance. The current study manifests the crucial role of CPD on the association between social impact and sleep disturbance, and timely intervention for CPD is warranted.

Predictors for Depression, Sleep Disturbance, and Subjective Pain among Inpatients with Depressive Disorders during the COVID-19 Pandemic: A Cross-Sectional Study

The coronavirus disease 2019 (COVID-19) pandemic can have a negative impact on patients with mood disorders. The aim of this study is to explore the societal influence of COVID-19 and associated impacts on levels of depression, sleep disturbance, and subjective pain among patients with mood disorders. This cross-sectional study recruited inpatients with depression and bipolar disorder. Levels of depression, sleep disturbance, subjective pain, and related demographic variables were collected through self-reported questionnaires. Potential factors associated with levels of depression, sleep disturbance, and subjective pain were identified using univariate linear regression and further entered into a stepwise multivariate linear regression model to identify the independent predictors. A total of 119 participants were included in the analysis, of whom 50.42% had bipolar disorder and 49.58% had unipolar depression. Multivariate analysis showed that a higher level of depression was associated with female subjects, subjects with partners, present history of psychological trauma, and drinking alcohol. Sleep disturbance was associated with subjects with partners and drinking alcohol. A higher level of subjective pain was associated with a higher level of social anxiety and a history of psychological trauma. The current study identified several predictors of psychological burden and subjective pain among inpatients with depression during the COVID-19 pandemic. Further investigations are warranted to extend the application and generalizability of our results.

Influence of trauma on clinical outcomes, quality of life and healthcare resource utilization following psychogastroenterology intervention

IntroductionPatients with disorders of gut-brain interaction (DGBI) are more likely to report a history of psychological trauma, including abuse, compared with controls. The purpose of this study was to evaluate the prevalence of trauma amongst patients in a GI behavioral health program and assess the impact of trauma on GI-specific quality of life, psychological distress, and healthcare utilization. MethodsWe conducted a retrospective analysis for 205 patients who completed treatment in the GI behavioral health program. Measures included the IBS-QOL and the Brief Symptom Inventory-18 (BSI-18), as well as a retrospective chart review to examine healthcare utilization (HCU). ResultsPatients with a trauma history had significantly greater psychological distress on the BSI-18 compared with controls (63.32 vs 57.40, p < .001). Patients with trauma also endorsed significantly poorer GI-specific QOL compared with controls (54.57 vs 64.15, p = .001). Patients with and without trauma demonstrated improvements in distress and GI-specific QOL following behavioral treatment. Comparison of one year pre and post treatment HCU revealed a mean decrease in HCU from 6.87 contacts to 4.21 contacts per year. ConclusionsIn a sample of GI behavioral health patients, those with a history of trauma endorsed higher levels of distress and poorer GI-specific QOL at baseline. Both groups benefitted equally from behavioral treatment. The impact of GI behavioral treatment on patient mental health, GI-specific quality of life and HCU lends support to the assessment of patient trauma history by gastroenterologists in order to provide more comprehensive treatment for their GI health.

The relationships between resilience of the adults affected by the covid pandemic in Turkey and Covid-19 fear, meaning in life, life satisfaction, intolerance of uncertainty and hope

The current study was conducted to investigate the association between the resilience of the adults affected by the Covid-19 pandemic and Covid-19 fear, meaning in life, life satisfaction, intolerance of uncertainty, hope gender, psychological trauma history and the presence of the individuals diagnosed with Covid-19 around. A total of 929 adults with the mean age of 41.58 participated in the current study. Findings from the study indicated that hope, meaning in life, life satisfaction, not having the experience of psychological trauma positively and significantly predict resilience while intolerance of uncertainty and Covid-19 fear negatively and significantly predict resilience. The presence of people diagnosed with Covid-19 and gender on the other hand were found to not significantly predict resilience.

Microstructural integrity of affective neurocircuitry in patients with dissociative seizures is associated with emotional task performance, illness severity and trauma history

PurposeTo identify variations in white matter tract integrity related to behavioural control in response to emotional stimuli in patients with dissociative seizures (DS) and healthy controls (HC), and examine associations with illness characteristics and psychological trauma history. MethodsTwenty DS patients and 20 HC completed an emotional go/no-go task and questionnaires, and then underwent diffusion tensor imaging (DTI). ResultsPatients had higher false alarm rates in response to negative emotional stimuli than HC. Task performance was correlated with self-reported difficulties in emotional awareness and regulation in everyday life. White matter analysis using tract-based spatial statistics revealed no between-group differences. In patients, fractional anisotropy (FA) in the right uncinate fasciculus, right and left fornix/stria terminalis, and corpus callosum were correlated with task performance. Similar results were found for radial diffusivity (RD), but not mean (MD) or axial diffusivity (AD). In HC, task performance was associated with AD and RD of fewer and smaller clusters in the corpus callosum and right fornix/stria terminalis, and none for FA or MD. Probabilistic tractography of thus identified tracts revealed that mean FA values were correlated with illness parameters (right fornix/stria terminalis with age at onset; posterior corpus callosum with seizure frequency), and psychological trauma history (traumatic experiences during adolescence with anterior corpus callosum). ConclusionsPatients with DS show impaired behavioural control in response to emotional stimuli. Microstructural variations in task-related neurocircuitry show associations with illness parameters and psychological trauma history. Future studies using psychiatric controls should examine the specificity of these findings.

Clinical Manifestation of Patients Who Died Due to COVID-19; A Retrospective Study from Qom-Iran.

The coronavirus disease 2019 (COVID-19) has become a pandemic health problem worldwide. In this study, we attempted to explain the clinical and laboratories characteristics of non-surviving patients, to identify the probable factors affecting disease progression. In a retrospective study, we assessed the data from dead adult patients who were hospitalized and laboratory diagnosed with COVID-19 during March 2020. The data were obtained from electronic medical records. Moreover, a checklist including demographic, clinical, laboratorial, imaging, and treatment data was completed for each one of the patients. In case of lack of information, a member of the research team contacted the first-degree relatives via phone. Totally, 50 patients were enrolled in this study. The mean age was 68.0 ± 14.1 years. Of them, 29 (58%) patients were male. Notably, the median (IQR) hospitalization time was 4.0 (2.7-6.2) days and the duration between the first symptoms to death was 10.0 (5.0-14.5) days. Also, pre-existing morbidity was reported in 42 (84%) patients, and hypertension was the most common one with 28 (54%) patients. Interestingly, body temperature more than 37.5°C was reported in only 20 (40%) patients. Nevertheless, neutrophilia (≥7109/L) and lymphopenia (<1.0 109/L) were observed in 27 (54%) and 29 (58%) patients, respectively. Also, elevated levels of creatinine, lactate dehydrogenase (LDH), erythrocyte sedimentation rate (ESR), and C-reactive protein (CRP) were common, which may be indicators of aggravation of the patients' status. Besides age and underlying diseases, elevated creatinine level, neutrophil count, and the inflammatory indices along with the reduced lymphocyte count can be considered as indicators of disease progression. Hence, they should be considered for admission and surveillance of patients.

Irritable Bowel Syndrome: Psychological Disorder or Poverty? Results of a Large Cross-sectional Study in Iran

Irritable bowel syndrome (IBS) is a functional disease with no exact laboratory or imaging findings. IBS is more common in areas with a history of psychological trauma and war. This study aims to report the prevalence and possible determinants of IBS in southwestern Iran, an area with a notable history of war. We randomly enrolled 1849 permanent residents in 29 cities aged 20 to 65 years. A validated for Farsi version Rome III criteria and a questionnaire, including demographic data and health history, were administered to each subject. Participants who fulfilled the Rome III criteria were categorized into three groups: Diarrhea dominant (IBS-D), Constipation dominant (IBS-C), and Mixed type (IBS-M). The total prevalence of IBS was 3.2%, with 70% of subjects being of Arab descent (P=0.004). IBS was more common in females, singles, illiterate subjects, and people younger than 30 years; however, none of these differences were statistically significant. People with depression, anxiety, self-report of psychological disorders, and very low socioeconomic status had a significantly higher prevalence of IBS (P<0.05). After multivariable logistic regression analysis, very low socioeconomic status had an independent role in IBS predictivity (OR: 2.28, 95% CI: 1.01-5.15). This study shows a higher prevalence of IBS symptoms in a population-based study in the region compared to counterparts in other regions of Iran. Considering the higher prevalence of self-reported psychological disorders, further studies are recommended to focus on the exact diagnosis of mental disorders and their influence on IBS.

A Universal, Trauma-Informed Approach to Pediatric Hospital Medicine.

Olivia, a 13-year-old neurologically intact patient with cerebral palsy, arrived from a routine abdominal procedure screaming in pain. The medical team was baffled as to why she experienced such agony despite receiving copious doses of morphine. We spoke with her adoptive parents to obtain more history. They revealed long-standing physical and sexual abuse before Olivia’s adoption 6 years ago and noted extreme distress to all medical procedures and prolonged surgical healing time. Although her parents hoped to give her a better life and ensure she received appropriate care for her condition, they felt helpless that Olivia was at risk for retraumatization (reexperiencing posttraumatic symptoms from her original traumas) each time she came to the hospital. The amplification of pain and delayed medical recovery secondary to a history of psychological trauma and adverse childhood experiences (ACEs) is well recognized.1–3 Health care institutions are aware of the need for the integration of trauma-informed care into practice, yet they struggle to find the right approach. Although screening for ACEs has been widely adopted as a trauma-informed practice, there are multiple concerns with ACEs screening, including operating from a deficit- versus strength-based model, risk for traumatization from screening, and limited follow-up resources.4 ACEs scores also do not fully capture trauma and posttraumatic stress symptoms, which may be better predictors of negative outcomes than ACEs alone. Many organizations have now implemented the Substance Abuse and Mental Health Services Administration guidelines of educating clinicians on realizing …

TOLERANCE OF UNCERTAINTY AND EXECUTIVE DYSFUNCTION IN PEOPLE WITH PSYCHOLOGICAL TRAUMA

The aim of this study was to determine the effect of tolerance of uncertainty on the executive functions in people with psychological trauma. To study the neuropsychological correlates of tolerance of uncertainty in people with psychological trauma, 55 subjects aged 21 to 66 years (25 men and 30 women) were involved. The control sample included 56 subjects aged 22–67 years (21 men and 35 women). Research methods: "New questionnaire of tolerance-intolerance of uncertainty", "Iowa Gambling Task", Clinician-Administered PTSD Scale for DSM-IV (CAPS-DX), Method of verbal-color interference (Stroop test). Results: psychological trauma causes a decrease in the level of tolerance of uncertainty (ToU), an increase in the level of intolerance of uncertainty (IoU) and an increase in the level of interpersonal intolerance of uncertainty (IIoU). ToU can be seen as a protective factor in the case of psychological trauma. ToU can alleviate the manifestations of executive dysfunction (when treating both ambivalent and indeterminate stimuli) in people with a history of psychological trauma. IoU can be considered as a psychological construct that interferes with the normal functioning of executive functions in the control group (persons without a history of psychological trauma). Psychological trauma causes an increase in the level of IIoU in a way that is not associated with executive dysfunction.

HUBUNGAN RIWAYAT TRAUMA PSIKOLOGIS DENGAN KEJADIAN ISOLASI SOSIAL PADA PASIEN SKIZOFRENIA DI RUMAH SAKIT KHUSUS JIWA SOEPRAPTO PROVINSI BENGKULU

Schizophrenia is disorders associated with psychosis consisting of a group of clinical syndromes that are expressed with abnormalities in the contents of thought organizations, interpretation of sensory input, affective / emotional tension, will identity, psychomotor behavior, and the ability to establish satisfying interpersonal relationships. The purpose of this study was to study the relationship between the history of psychological trauma and the incidence of social isolation in schizophrenic patients at Soeprapto Mental Hospital in Bengkulu Province. This type of research is observational analytic using correlational design and using total sampling techniques with inclusion and exclusion criteria for 40 respondents. The population of this study was in schizophrenia patients at Soeprapto Mental Hospital, Bengkulu Province. Date collection techniques with primary and Secondary. Results: From 40 people there were 9 people (22.5%) had a history of psychological trauma, 31 people (77.5%) had no history of psychological trauma, from 40 people there were 16 people (40.0%) social isolation and 24 people (60.0%) did not have social isolation, there was a history of psychological trauma and the incidence of social isolation in schizophrenic patients at the Soeprapto Mental Hospital in Bengkulu Province. It is hoped that the Soeprapto Mental Hospital of Bengkulu Province can provide appropriate treatment and education by using poster and leaflet media when the patient's family is undergoing treatment and increasing the coaching program for schizophrenia patients so social isolation does not occur.

A Multicenter Phase II RCT to Compare the Effectiveness of EMDR Versus TAU in Patients With a First-Episode Psychosis and Psychological Trauma: A Protocol Design.

BackgroundPatients with a first episode psychosis (FEP) who are admitted for the first time to a psychiatric hospital frequently have experienced prior psychological trauma. Additionally, 40–80% develop posttraumatic stress symptoms, which are summarized as a post-psychotic post-traumatic syndrome (PPS). Eye Movement Desensitization and reprocessing (EMDR) therapy could be an effective psychotherapy to treat a PPS and prior psychological traumas in this population.ObjectivesTo assess if EMDR therapy leads to: 1) a reduction of relapses after intervention, 2) an improvement of trauma-related, psychotic and affective symptoms, 3) an improvement of overall functioning, and 4) an improvement in quality of life.MethodsThis is a multicenter phase II rater-blinded randomized controlled trial in which 80 FEP patients with a history of psychological trauma will be randomly assigned to EMDR (n = 40) or to TAU (n = 40). Traumatic events will be measured by the Global Assessment of Posttraumatic Stress Questionnaire, the Cumulative Trauma Screening, the Impact of Event Scale-Revised, the Dissociative Experiences Scale, the Childhood Trauma Scale, the Holmes–Rahe Life Stress Inventory, and the Dissociative Experiences Questionnaire. Clinical symptomatology will be evaluated using the Suicide and Drug Consumption module of the International Neuropsychiatric Interview, Structured Clinical Interview for Positive and Negative Syndrome Scale, Young’s Scale for Mania Evaluation, and Beck Depression II Questionnaire. Functionality will be assessed with the Global Assessment of Functioning and the Quality of Life with the Standardized Instrument developed by the EuroQol Group. The cognitive insight and adherence to the treatment will be assessed with the Beck Cognitive Insight Scale and the Drug Attitude Inventory. All variables will be measured at baseline, post-treatment and at 12-month follow-up.ConclusionThis study will provide evidence of whether EMDR therapy is effective in reducing trauma and clinical symptoms, reducing relapses and in improving functionality and quality of life in patients with FEP and a history of trauma.Clinical Trial Registrationwww.ClinicalTrials.gov, identifier: NCT03991377

Pandemic COVID-19: the residents' resilience.

Background and aim of the work:Healthcare workers are often exposed to secondary traumatic stress. The SARS-CoV-2 outbreak caused intense psychological pressure in various healthcare professionals, with increased risk of post-traumatic stress disorder. Objective of our study was to evaluate the incidence of post-traumatic stress disorder in italian residents in Intensive Care and Emergency Departments facing COVID-19 emergency.Methods:We developed a short, anonymous web-questionnaire to obtain data regarding sociodemographic, professional characteristics, history of psychological trauma, psychotherapy, use of psychiatric medications and the presence of symptoms of post-traumatic stress disorder. Primary outcome was the incidence of post-traumatic stress disorder. Secondary endpoint was to identify possible risk factors associated with the development of post-traumatic stress disorder. Post-traumatic stress disorder symptoms were assessed by the Impact of Event Scale-Revised. A cut-off of 33 identified a probable diagnosis of post-traumatic stress disorder while a cut-off of 22 identified subclinical post-traumatic stress disorder.Results:503 residents completed the questionnaire. Among residents who were directly involved in the clinical assistance of COVID-19 patients, 34.3% presented a probable diagnosis of post-traumatic stress disorder, while 21.5% presented subclinical post-traumatic stress disorder. Female gender and history of psychological trauma were significantly associated with the development of post-traumatic stress symptoms.Conclusions:Our data suggest a high incidence of post-traumatic stress disorder in Italian residents working in Intensive Care Units and Emergency Departments during the SARS-CoV-2 outbreak. This finding supports the importance of promptly implementing any strategy that might preserve staff mental health. (www.actabiomedica.it)

Depression, anxiety, and clinical history in Spanish-speaking American patients with psychogenic nonepileptic seizures (PNES) compared with Spanish-speaking American patients with epilepsy

ObjectiveThe objective of this study was to compare Spanish-speaking American patients with epilepsy to Spanish-speaking American patients with psychogenic nonepileptic seizures (PNES) on depression, anxiety, and other clinical variables. BackgroundResearch on Spanish-speaking American patients with epilepsy or PNES is relatively infrequent, with only a few studies on psychopathology in these two patient groups. Studies of English-speaking patients indicate that those with PNES present with greater depression and anxiety and report poorer quality of life (QOL) when compared with persons with epilepsy (PWEs). Similarly, although psychological trauma is observed in both groups, those with PNES appear to have more traumatic exposure compared with PWEs. MethodsThis is a retrospective study of 74 Spanish-speaking PWEs (49 women, 31 men) and 34 Spanish-speaking patients with PNES (28 women, 4 men) (2004 to 2017). The diagnosis of epilepsy or PNES was confirmed with video-EEG. Demographic and clinical (psychological trauma, history of psychological treatment, etc.) data were collected, and Spanish versions of the Beck Depression Inventory — second edition (BDI-II) and Beck Anxiety Inventory (BAI) were completed by the patients. ResultsPatients with PWEs (M = 18.19, SD = 12.89) differed significantly from those with PNES on a measure of depression (BDI-II, (M = 24.12, SD = 11.20); t (92) = −2.22, p = 0.01). In addition, PWEs (M = 15.76, SD = 14.24) also differed significantly when compared with patients with PNES on a measure of anxiety (BAI, (M = 22.46, SD = 14.02); t (93) = −2.05, p = 0.02). Significant differences in clinical and demographic data were also noted. ConclusionsSpanish-speaking American patients with PNES were significantly more depressed and anxious and reported greater exposure to sexual trauma as compared with PWEs. Furthermore, patients with PNES tended to report more prediagnosis utilization of mental health services than PWEs. After adjusting for potential linear effects of other predictors (e.g., gender, age, seizure frequency, and psychological trauma), only a reported history of psychological trauma had a linear relationship with a depression score while higher seizure frequency and history of mental health treatment had linear relationships with an anxiety score.

A Rater-blinded RCT to Compare Effectiveness of EMDR vs TAU in Patients With First Psychotic Episode and History of Psychological Trauma

A Rater-blinded RCT to Compare Effectiveness of EMDR vs TAU in Patients With First Psychotic Episode and History of Psychological Trauma

Quality of life and psychological dysfunction in traumatized and nontraumatized patients with psychogenic nonepileptic seizures (PNES)

ObjectivesPsychogenic nonepileptic seizures (PNES) have the appearance of epileptic seizures, yet show no epileptiform discharges in the brain. The quality of life (QOL) in patients with PNES is reportedly low and trauma eems to be a relevant risk factor. The objective of this study was to examine the difference between measures of (epilepsy-specific) QOL (Quality of Life in Epilepsy Inventory; QOLIE-31p) and psychological dysfunction (trauma symptom inventory; TSI) between patients with diagnosed PNES with self-reported trauma and those without self-reported trauma. MethodsPatients whose PNES diagnoses were through video-electroencephalogram (EEG) monitoring at the Northeast Regional Epilepsy Group between 2008 and 2018 were included. Patients who reported to have a history of psychological trauma and those who did not were assigned to separate groups. Scores from the TSI and QOLIE-31p were compared by using multivariate analysis of covariance. ResultsThe total sample was comprised of 217 adult patients, 148 of which self-reported as having experienced psychological trauma in the past and 69 who did not report any psychological trauma. Traumatized patients significantly differed in terms of QOL and TSI from nontraumatized patients. Traumatized patients were demonstrated to have lower scores on the subdomain “energy” of the QOLIE-31p and the total QOLIE-31p score compared to the nontraumatized group. Similarly, the traumatized group had significantly higher scores on nearly all TSI subscales with the exception of suicidality, sexual disturbances, and somatization. ConclusionThis study demonstrated significant differences between patients with PNES who have been psychologically traumatized and those who have not. In particular, patients with a history of psychological trauma present greater psychopathology and would possibly benefit from rapid identification and referral to trauma-based therapy. In turn, this may result in a reduction of disease burden, increase QOL, and a reduction in healthcare costs resulting from diagnostic delays and implementation of less targeted treatments.

Psychological trauma, somatization, dissociation, and psychiatric comorbidities in patients with psychogenic nonepileptic seizures compared with those in patients with intractable partial epilepsy

ObjectiveThe objective of this study was to compare patients with intractable epilepsy with patients with psychogenic nonepileptic seizures (PNES) on the presence of psychological traumas, clinical factors, and psychological measures of somatization and dissociation. BackgroundSeveral studies have reported a high prevalence of psychological trauma in patients with PNES, while less have examined the prevalence of psychological trauma in patients with epilepsy and compared both groups. Reports have been somewhat divergent with some describing significantly higher prevalence in physical abuse, others, in emotional abuse/neglect, and others, in sexual abuse in patients with PNES compared with those in patients with epilepsy. MethodsThis is a retrospective study of 96 patients (61 women, 35 men) with intractable epilepsy (2009 to 2017) and 161 patients (107 women, 54 men) with PNES (2008 to 2018).Demographic and clinical (psychological trauma, depression, anxiety, seizure frequency, and number of antiepileptic drugs) data were collected. The Trauma Symptom Inventory II and the Minnesota Multiphasic Personality Inventory 2RF were administered. ResultsPatients with PNES differed significantly from those with intractable epilepsy on sexual trauma (χ2 (5df, N = 257) =9.787, p < .002) and “other” trauma (χ2 (5df, N = 257) = 17.9076, p < .000). On psychological measures, there was a significant difference on Somatization scores in patients with PNES (M = 59.63, SD = 11.47) and patients with intractable epilepsy (M = 53.98, SD = 11.31); t(173) = 2.8396, p = .0051, but no difference was noted on a measure of Dissociation. Subsequent principal components analysis revealed that the first 3 principal components (sexual, physical, and other trauma) explained 74.19% of the variability, and that one principal component (dissociation, somatization, demoralization) explained 61.57% of the variability. However, after adjusting for the effects of covariates, only the presence of trauma discriminated between epilepsy and PNES. ConclusionsPatients with PNES diagnoses differed from those with epilepsy on a Somatization scale but not on Dissociation or Intrusive Experiences and exhibited significantly higher rates of sexual and “other” trauma compared with those with intractable epilepsy. However, subsequent analyses revealed that a history of psychological trauma was the only condition found to discriminate between patients with PNES and those with epilepsy. These findings suggest that during initial workup and diagnosis, when patients report a history of psychological trauma (sexual or otherwise) a psychogenic nonepileptic etiology should be strongly considered in the differential diagnosis.

Relationship of severity of ADHD symptoms with the presence of psychological trauma while controlling the effect of impulsivity in a sample of university students

ObjectiveThe aim of the present study was to evaluate relationship of severity of ADHD symptoms with the presence of psychological trauma while controlling the effect of impulsivity in a sample of university students.MethodParticipants included 321 volunteered university students. Participants were evaluated with the Short Form Barratt Impulsiveness Scale (BIS-11-SF), the Adult ADHD Self-Report Scale (ASRS) and the Traumatic Experiences Checklist (TEC).ResultsAge and gender did not differed between those with the history of psychological trauma (n = 271, 84.4%) and those without (n = 50, 15.6%). BIS-11-SF and subscale scores did not differ between groups, other than motor impulsivity, which was higher among those with the history of psychological trauma. ASRS score, inattentiveness and hyperactivity/impulsivity subscale scores were higher among those with the history of psychological trauma than those without. Severity of ADHD symptoms, particularly inattentiveness score, predicted the presence of psychological trauma, together with the severity of motor and attentional impulsivities in a logistic regression model.ConclusionThese findings suggest that the severity of ADHD symptoms may be related with the presence of psychological trauma, while severity of motor and attentional impulsivities may have an effect on this relationship among young adults.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Resultados preliminares de la aplicación del Eye Movement Desensitization and Reprocessing en pacientes con dolor lumbar crónico inespecífico

Non-specific chronic low back pain (NCLBP) is a common and disabling condition in the adult population, which generates significant costs due to the healthcare and occupational burden of the condition. Previous studies have shown the relationship between NCLBP and the presence of traumatic emotional experiences as a possible aetiological factor and as a poor prognostic indicator. This study recruited 11 patients suffering from NCLBP and with a history of psychological trauma. In a randomised controlled design, Eye Movement Desensitization and Reprocessing was administered to half of the sample (n=6) to study its effects on both physical and psychological pathology. This article presents the comparative results of the experimental group and the control group in terms of the experience of pain and perceived quality of life, when trauma-associated psychological variables are treated.

Trauma-Informed Hospice and Palliative Care.

This review highlights the need to integrate trauma-informed practices into hospice and palliative care. The pervasiveness of psychological trauma exposure has been established in the general population and among the elderly adults. Moreover, there is emerging evidence for multiple additional opportunities for exposure to psychological trauma at or near the end of life. For example, many people experience intensive medical interventions prior to their admission to hospice and/or palliative care, and there is increasing recognition that these interventions may be traumatic. These and related opportunities for trauma exposure may combine synergistically at the end of life, particularly in the presence of pain, anxiety, delirium, dementia, or ordinary old age. This, in turn, can negatively affect patient mental health, well-being, behavior, and reported experience of pain. This review closes with suggestions for future research and a call for universal assessment of psychological trauma history and symptoms in hospice and palliative care patients, along with the development of palliative trauma intervention strategies appropriate to these populations.

Acute mental disorders and short and long term morbidity in patients with third degree flame burn: A population-based outcome study of 96,451 patients from the Nationwide Inpatient Sample (NIS) database (2001–2011)

BackgroundAlthough burn patients with preexisting mood disorders have been shown to have diminished clinical recovery, acute mental disorders (AMD) are often unrecognized despite a link with post-traumatic stress disorder and social maladjustment later on. This study assessed the clinical profile of a large cohort of burn patients who developed AMD compared to those with chronic mental illness (CMI) and those without mental health problems to assess the impact of AMI on burn outcomes. MethodsAdmission data on 96,451 patients with third degree flame burns was abstracted from the Nationwide Inpatient Sample (NIS) Database from 2001 to 2011. AMD was defined as adjustment disorder (ICD-10 codes F43.2–F43.29) and acute stress disorder (F43.0), while CMI was defined as major depressive disorder (F33.0–F33.9) and bipolar disorder (F31.0–F31.9). Data was compared across three subgroups: AMD, CMI, and patients without any mood disorders. Categorical variables were compared using the Chi-square test, and continuous variables were compared using Student t-test and analysis of variance (ANOVA). Multivariate analysis using the “backward Wald” method was performed to calculate odds ratios (OR) and determine independent factors which increased the risk of developing AMD after burn. Results979 (1%) burn patients were diagnosed with AMD, compared to 5971 (6.2%) with CMI and 89,501 (92.8%) without mood disorders at the time of the burn. Patients with AMD were significantly younger, predominantly male and Caucasian. Patients with AMD had a higher frequency of multiple third-degree burn sites. AMD patients had a significantly longer length of hospitalization and shorter actuarial survival. More AMD patients lacked social or family support, suffered from alcoholism or illicit drug abuse, and had a history of psychological trauma or self-inflicted injuries compared to other groups. After burn, 4.9% of AMD patients developed burn wound infections, 5.0% had nutritional deficiencies, 1.7% had skin graft failure, 0.7% had acute psychosis, and 3.7% had suicidal ideation, p<0.05. Multivariate analysis identified age 10–39 (OR 4.6), alcoholism (OR 1.4), drug abuse (OR 1.9), psychoses (OR 1.4), and total body surface are (TBSA) 10–39% third degree burns (OR 1.8) as independently associated with developing AMD, p<0.005. ConclusionThe development of AMD in burn patients is associated with poor clinical outcomes including longer hospitalization, decreased survival, and increased complication rates. Premorbid psychopathology, substance abuse and age were associated with a higher incidence AMD after burn than was the severity of the burn wound itself. Routine screening for psychological symptoms of AMD should be performed in all burn patients to avoid increased rates of short and long-term morbidity and mortality.