Posttraumatic Stress Disorder Intensity Research Articles

Association Between Intimate Partner Violence (IPV) and Physical, Psychological, and Social Health Outcomes for Women in Bangladesh

Background: Intimate partner violence (IPV) is a global issue impacting 1 in 3 women worldwide. IPV has been shown to have direct impact on the physical, psychological, and social aspects of life and overall well-being. Objective: The purpose of this study was to explore associations between report of IPV and physical, psychological, and social health outcomes with special emphasis on relationship of IPV to pelvic floor, pelvic pain, and urinary incontinence for Bangladeshi women. Study Design: A cross-sectional study was conducted using purposive sampling. Methods: Married women between 18 and 50 years were recruited in the study. IPV was measured using the Hurt-Insult-Threaten-Scream (HITS) screening tool and complex trauma was measured utilizing the Complex Trauma Inventory (CTI) Scale. Data were analyzed through SPSS version 21.0, and reported as descriptive statistics. Results: The total number of the respondents was n = 100. The mean age of respondents was 36.57 years (standard deviation ± 9.66). According to the HITS screening tool 27% respondents reported IPV. There was a significant, strong correlation between HITS scores for IPV and negative health outcomes of chronic disease and disability (r = 0.8; P ≤ .05). There was a direct association between HITS scores and (1) CTI scores for complex trauma, (2) pelvic floor dysfunction, and (3) duration of marriage. Conclusion: High prevalence of IPV was reported for this cohort of women living in Bangladesh. HITS scores for IPV were direct significant associations with severity and intensity of posttraumatic stress disorder on the CTI, and with low back pain, pelvic floor dysfunction, postpartum complications, and cardiac problems.

A Cross-Sectional Study of Psychiatric Comorbidity in Croatian Homeland War Veterans Who Were Held as Prisoners of War and Are Affected by Posttraumatic Stress Disorder.

As a extremely traumatic experience, captivity may cause other mental disorders in addition to posttraumatic stress disorder, which is highly prevalent among ex-prisoners of war, and which often occurs in comorbidity with at least one other mental disorder. This objective of this study is to identify the incidence of comorbid mental disorders in Homeland war veterans ex-prisoners of war affected by posttraumatic stress disorder, as well as to identify the factors that influenced psychiatric comorbidity. The study sample comprised 264 subjects, all of whom were Croatian Homeland War veterans with combat experience in the defence of the Republic of Croatia, and all of whom fulfilled clinical criteria for posttraumatic stress disorder at the time of the study. The subjects were divided into two groups: the experimental group was composed of ex-prisoners of war, and the control group of veterans who had never been prisoners of war. The methods of sociodemographic questionnaire, posttraumatic stress disorder self-report checklist and the Harvard Trauma Questionnaire were used in the study. Psychiatric comorbidity data were retrieved from the subjects' anamnesis and medical records. The results showed that ex-prisoners of war were exposed to a statistically much higher number of traumatic events, and had a significantly higher total number of psychiatric comorbidities (p<0.01) than the control group. The incidence of acute and transient psychotic disorders, generalized anxiety disorders and psychological and behavioural factors associated with disorders or diseases classified elsewhere was significantly higher among ex-prisoners of war. There was no statistically significant difference in overall posttraumatic stress disorder intensity between the two groups (p<0.05). The results of the study confirm our hypothesis that the incidence of psychiatric comorbidity is higher in ex-prisoners of war.

The Role of Perceived Social Support in Assessing Posttraumatic Stress Disorder and Mental Health-Related Quality of Life in Veterans.

This study aims to establish the effect of self-perceived social support on the intensity of Post-Traumatic Stress Disorder (PTSD) symptoms and Mental Health-Related Quality of Life (MHRQoL) in veterans more than two decades after exposure to trauma in the Homeland War in Croatia, which took place from 1990 to 1995. The sample comprised 259 Croatian Homeland War veterans diagnosed with PTSD, with at least 6 months of combat experience. Among them, 90 subjects had also experienced imprisonment in enemy prison camps (at least 1 month of captivity). The subjects were evaluated using the questionnaire on self-perceived social support, sociodemographic questionnaire, PTSD self-report checklist (PCL-5) and Short Form (SF-36) Health Survey questionnaire. A general regression model analysis was performed to determine whether social support affected patients’ MHRQoL and intensity of the PTSD symptoms. The obtained results showed that veterans who had a more positive perception of social support after the events of the war had less intense PTSD symptoms and better MHRQoL. Furthermore, captivity and socioeconomic status were shown to be important predictors of PTSD and MHRQoL. The nonimprisoned veteran group was more likely to develop more severe PTSD symptoms and have poorer MHRQoL compared to the group of former prisoners of war (ex-POWs). This could be due to better post-war care and social support, which ex-POWs received after their release from captivity.

Social capital and mental health problems among Syrian refugee adolescents: The mediating roles of perceived social support and post-traumatic symptoms

Social capital is one of the prominent components of refugee mental health. However, its role on mental health is poorly understood. The aim of the present study was to investigate the nature of the association between social capital and mental health problems in refugee adolescents. A cross-sectional study with three hundred twenty-one 12- to 18-year-old Syrian refugee adolescents was conducted in Turkey. We administered the Arabic versions of the following instruments in school settings: The Social Trust, Multidimensional Scale of Perceived Social Support (MSPSS), The Children's Impact of Event Scale (CRIES-8) and The Strengths and Difficulties Questionnaire (SDQ). The mediation analyses with Hayes' PROCESS Macro revealed that perceived social support and the intensity of post-traumatic stress disorder (PTSD) symptoms fully mediated the relationship between social capital and mental health problems. The results suggested social trust's two distinct functions which impair the likelihood of mental health problems: (a) social trust might help to facilitate perceived social support from family and friends and (b) social trust might impair the intensity of traumatic experiences.

P.4.b.025 Association between symptoms of posttraumatic stress disorder and blood pressure in the elderly

To examine the frequency and intensity of posttraumatic stress disorder (PTSD) symptoms and their relation to clinical impairment, to examine the requirement of meeting all DSM-IV symptom cluster criteria (i.e., criteria B, C, D), and to examine the aggregation of PTSD symptom clusters across developmental stages.Fifty-nine children between the ages of 7 and 14 years with a history of trauma and PTSD symptoms were assessed with the Clinician-Administered PTSD Scale for Children and Adolescents.Data support the utility of distinguishing between the frequency and the intensity of symptoms in the investigation of the phenomenology of pediatric PTSD. Children fulfilling requirements for two symptom clusters did not differ significantly from children meeting all three cluster criteria with regard to impairment and distress. Reexperience (cluster B) showed increased aggregation with avoidance and numbing (cluster C) and hyperarousal (cluster D) in the later stages of puberty.Frequency and intensity of symptoms may both contribute to the phenomenology of pediatric PTSD. Children with subthreshold criteria for PTSD demonstrate substantial functional impairment and distress.

Do gender and age moderate the symptom structure of PTSD? Findings from a national clinical sample of children and adolescents

A substantial body of evidence documents that the frequency and intensity of posttraumatic stress disorder (PTSD) symptoms are linked to such demographic variables as female sex (e.g., Kaplow et al., 2005) and age (e.g., Meiser-Stedman et al., 2008). Considerably less is known about relations between biological sex and age with PTSD's latent factor structure. This study systematically examined the roles that sex and age may play as candidate moderators of the full range of factor structure parameters of an empirically supported five-factor PTSD model (Elhai et al., 2011). The sample included 6591 trauma-exposed children and adolescents selected from the National Child Traumatic Stress Network's Core Data Set. Confirmatory factor analysis using invariance testing (Gregorich, 2006) and comparative fit index difference values (Cheung and Rensvold, 2002) reflected a mixed pattern of test item intercepts across age groups. The adolescent subsample produced lower residual error variances, reflecting less measurement error than the child subsample. Sex did not show a robust moderating effect. We conclude by discussing implications for clinical assessment, theory building, and future research.

Cranial Electrotherapy Stimulation in the Treatment of Posttraumatic Stress Disorder: A Pilot Study of Two Military Veterans

This case study investigated the effects of cranial electrotherapy stimulation (CES) on the prevalence and intensity of posttraumatic stress disorder (PTSD) symptoms and self- perceived improvement of performance and satisfaction in daily activities in war veterans. Two male Caucasian veterans (ages 54 and 38) diagnosed with PTSD participated in these case studies with a pretest–posttest design. The Canadian Occupational Performance Measure (COPM) and the PTSD Symptom Scale–Interview (PSS-I) were administered before and after the 4-week CES treatment. The participants self-administered the 4-week CES treatment protocol using Alpha-Stim SCS CES device in their home for 20 to 60 min a day, 3 to 5 days a week with a comfortable, self-selected, current level between 100 and 500 microamperes. They were asked to document the settings and responses in a daily treatment log. Through visual trend analysis and change scores, the results revealed daily PTSD symptoms decreased in frequency and severity for both parti...

Search for a curvilinear relationship between the sense of coherence and the intensity of PTSD in MVA survivors

The relationship between the sense of coherence (SOC) and the intensity of posttraumatic stress disorder (PTSD) was examined in order to determine its nature and to resolve the inconsistencies between (1) a growing body of empirical research that indicates a linear relationship between these variables, and (2) the schema-based theories of PTSD that suggest a curvilinear relationship between cognitions and the intensity of PTSD. In this cross-sectional study an attempt was also made to identify some psychological factors that moderate this relationship. Participants were a sample of 1132 motor vehicle accident (MVA) survivors. The results showed that gender and temperamental predisposition to PTSD constituted moderator variables of the relationship between SOC and the intensity of PTSD. This supported both the empirical evidence on the linear and negative relationship between SOC and the intensity of PTSD and the theories that postulated the curvilinear relationship.

P02-372 - Social and demographic factors and severity of symptoms of posttraumatic stress disorder in victims of intimate partner violence

Intimate partner violence (IPV) has been recognized as a prevalent social problem and a source of mental health problems for women. The most common psychiatric difficulty in battered women is posttraumatic stress disorder (PTSD). The aim of this study was to assess the prevalence and intensity of posttraumatic stress disorder among a group of victims of intimate partner violence, as well as the association between some socio-demographic factors and increased risk to develop posttraumatic stress disorder (PTSD).Research method1.Diagnosis and a degree of intensification of PTSD were based on C.G. Watson's at al. PTSD-Interview.2.Semi-structured interview was completed by 104 women to assess risk factors of PTSD (social, demographic and clinic).The examined group consisted of 104 women at the age between 18 and 68 years, the average age 40,8 years; dwelling in the shelters for single mothers and domestic violence victims and out-patients of psychiatric ambulatory.Results75,6% of women who are victims of interpersonal violence had significant, very significant or extreme increase of occurrence of PTSD symptoms. PTSD severity was associated with lower level of education and sexual violence.ConclusionVictims of interpersonal violence are inherently at risk of PTSD. Lower level of education and sexual type of interpersonal violence are risk factors of severity PTSD.

Prevalence and correlates of posttraumatic stress disorder among Kuwaiti military men according to level of involvement in the first Gulf War

First, to compare the prevalence and intensity of posttraumatic stress disorder (PTSD) among Kuwaiti military men, divided into four groups (50 subjects each) according to degree of exposure to war trauma: (1) the retired (retired before the invasion); (2) an active-in-the-army group (AIA) (involved in duties at the rear only); (3) an in-battle (IB) group (involved in combat); and (4) prisoners of war (POWs-captured during combat). Second, to compare the severity of impact of event, comorbid depression, and anxiety among the groups. Third, to evaluate the contribution of self-esteem and locus of control (LOC). Subjects were interviewed once, 6 years after the war, using: the Clinician Administered PTSD Scale; the Impact of Event Scale (IES); the Hopkins Symptom Checklist-25; the Internal-External LOC; and The Self-Esteem Scale. Subjects were aged 24-71 years (mean 37.9). Sixty-three subjects (31.5%) fulfilled criteria for PTSD, with the rate significantly higher among the POWs (48%) than the retired (24%) and IB (22%), reflecting the severity of IES. Avoidance symptoms were the most pronounced. Self-esteem was significantly lowest among the POWs and those with PTSD. External LOC was associated with PTSD, anxiety, and depression. Self-esteem was the only covariate of PTSD scores. LOC was a significant covariate for anxiety. The characteristics of PTSD in these veterans showed similarity with those from elsewhere. The prominence of self-esteem and avoidance symptoms implies that they should be part of focus for interventions. Focus on LOC should be from the perspective of anxiety.

Prediction of the occurrence and intensity of post-traumatic stress disorder in victims 32 months after bomb attack

Introduction. – Our objective was to identify factors that predict occurrence and severity of post-traumatic stress disorder (PTSD) after a terrorism attack. Population. – We evaluated 32 victims of a bomb attack in a Paris subway in December 1996 at 6 and 32 months. Method. – Sociodemographic characteristics, clinical data and physical injuries were used to predict PTSD occurrence and severity in 32 victims. The Watson’s PTSD Inventory (PTSD-I) and the Impact of Event Scale (IES) by Horowitz were used to evaluate occurrence and severity of PTSD, respectively. Results. – Thirty-nine percent of participants met PTSD criteria at 6 months, 25% still had PTSD at 32 months. Women had PTSD 32 months after the bomb attack more frequently than men. Employment predicted PTSD severity at 32 months. PTSD scores assessed by PTSD-I at 6 months were significantly and positively associated with IES scores at 32-month follow-up ( r = 0.55, P = 0.004). Psychotropic drug use before the bomb attack significantly predicted PTSD occurrence and severity at 6 and 32 months. In a linear regression model, physical injuries, employment status and psychotropic drug use before the bomb attack were independent predictors of severity of PTSD at 32 months. Conclusions. – Bomb attack exposure resulted in persisting PTSD in a significant proportion of victims; the severity was predicted at 32 months by physical injuries and psychotropic drug use before the terrorism attack and by the PTSD score few months after the bomb attack.

Toward an Empirical Definition of Pediatric PTSD: The Phenomenology of PTSD Symptoms in Youth

To examine the frequency and intensity of posttraumatic stress disorder (PTSD) symptoms and their relation to clinical impairment, to examine the requirement of meeting all DSM-IV symptom cluster criteria (i.e., criteria B, C, D), and to examine the aggregation of PTSD symptom clusters across developmental stages. Fifty-nine children between the ages of 7 and 14 years with a history of trauma and PTSD symptoms were assessed with the Clinician-Administered PTSD Scale for Children and Adolescents. Data support the utility of distinguishing between the frequency and the intensity of symptoms in the investigation of the phenomenology of pediatric PTSD. Children fulfilling requirements for two symptom clusters did not differ significantly from children meeting all three cluster criteria with regard to impairment and distress. Reexperience (cluster B) showed increased aggregation with avoidance and numbing (cluster C) and hyperarousal (cluster D) in the later stages of puberty. Frequency and intensity of symptoms may both contribute to the phenomenology of pediatric PTSD. Children with subthreshold criteria for PTSD demonstrate substantial functional impairment and distress.

An Ethnocultural Study of Posttraumatic Stress Disorder in African-American and White American Vietnam War Veterans

This study examined the intensity of Posttraumatic Stress Disorder (PTSD) symptoms as measured by the Mississippi Scale, the Keane (PK), and the PTSD (PS) Scales of the MMPI-2 in a sample of 34 African-American and 34 White American Vietnam War Veterans who sought treatment in a Specialized Inpatient PTSD Unit. The scores of the two groups on the Beck Depression Inventory and the clinical scales of the MMPI-2 were also compared. The ethnoculturally different sample was matched on intensity of combat exposure, marital status, employment status, age, and education. No significant differences on the measures of PTSD symptoms were noted and no significant differences were found on the Beck scale or the MMPI-2 clinical scales.

War-induced psychic trauma: an 18-year follow-up of Israeli veterans.

Eighteen years after their participation in the Yom Kippur War, the psychiatric status of two groups of Israeli veterans--112 combat stress reaction casualties and 189 comparable controls--was assessed. Casualties had higher rates and greater intensity of posttraumatic stress disorder than did controls, both initially and at 18-year follow-up. Similarly, intrusion and avoidance tendencies and psychiatric symptomatology were evidenced more often by combat stress reaction casualties than by controls. Clinical implications of the findings are discussed.

The relationship between traumatic exposure, family dysfunction, and post-traumatic stress symptoms in male juvenile offenders.

This study examined some chronic, stressful conditions and some acute, traumatic events which may place youths at risk for specific types of psychopathology. Ninety one delinquent adolescents with histories of serious and repeated crimes were assessed for their exposure to 11 different types of trauma. The subjects were also tested using measures which assess family functioning, and frequency and intensity of Post-Traumatic Stress Disorder (PTSD) symptoms. Results indicated that 24% of the subjects tested met full DSM III-R criteria for PTSD. Both exposure to violence and family dysfunction were significantly associated with PTSD symptomatology. These findings suggest that juvenile offenders may constitute a high risk group for exposure to multiple types of trauma and the development of post-traumatic stress symptoms related to such exposure. This study provides a rationale for future cross-trauma research both within the juvenile offender population and between it and other identified trauma groups.