Intrusive Symptoms Research Articles

The Effectiveness of the Single Object Burying Test in Assessing Hypervigilance-like Behavior in the Single Prolonged Stress Model of Post-Traumatic Stress Disorder (PTSD) in Male Sprague Dawley Rats

Abstract Introduction Post-traumatic stress disorder (PTSD) is recognized nowadays as a major public health issue. It arises as a long-term reaction to severe stressors considered to be life-threatening. It’s characterized by intrusive symptoms, avoidance, and hypervigilance. Although its prevalence is rather high, the mechanisms behind this serious condition are little understood, and its treatment is currently challenging. To get insights into this disorder, a variety of PTSD models were developed in the last 15 years as well as several tests have been proposed to assess the PTSD-like behaviors in these animal models. The single object burying test (OBT) was used to examine the hypervigilant behavior in electric shock animal model of PTSD. To the best of our knowledge, no prior studies have utilized the OBT to assess hypervigilance in the traditional single prolonged stress (SPS) animal model of PTSD. Our study aims to compare the behavioral response of the SPS-exposed and SPS-unexposed rats in the OBT. Methods This study employed the single prolonged stress (SPS) model to induce PTSD in male Sprague-Dawley rats (n = 12 rats, divided as control group = 6 rats, and SPS group = 6 rats) to investigate whether the single object burying test can detect the hypervigilance like behavior in the SPS rats as compared to control group. Parameters used are the percentage of time spent manipulating the object and the percentage of time spent burying the object. Results SPS rats demonstrated decrease in the percentage of time spent manipulating the object and increase in the percentage of time spent burying the object as compared to control group in the OBT. These responses are interpreted as hypervigilance like behavior. Conclusion The OBT can be considered a successful test in assessing hypervigilance of the rats exposed to the SPS animal model of PTSD

The association between PTSD symptom clusters and religion/spirituality with alcohol use among first responders

Alcohol misuse and posttraumatic stress disorder (PTSD) co-occur at high rates among first responders (e.g., law enforcement, firefighters, paramedics), underscoring the need to better understand these relations to inform intervention efforts. Identifying malleable processes relevant to the association between PTSD and alcohol among first responders could inform tailored interventions. An example of such a malleable process is spirituality. As such, the current study examined the unique relationships between PTSD symptom clusters and alcohol misuse, while also accounting for the role of select demographics and religion/spirituality, in a sample of first responders. A national online sample of first responders (N = 320) completed measures of PTSD symptomology, alcohol misuse, religion/spirituality and demographics. Hierarchical linear regression analyses revealed that PTSD Intrusion (Cluster B) symptom severity was associated with greater alcohol misuse and PTSD Avoidance (Cluster C) was associated with lower alcohol misuse. Additionally, positive and negative spiritual coping were also associated with alcohol misuse. In the context of similar research among military samples, findings suggest potentially unique associations between PTSD symptom clusters and alcohol misuse among first responders. Additionally, findings highlight the potentially protective role of religion/spirituality in this population. Future research should explore nuanced relationships between PTSD symptom clusters and alcohol misuse as well as the salience of spirituality/religion in this unique population.

A concept analysis of psychological trauma in labour and delivery nurses.

To facilitate an understanding of the risk for psychological trauma in labour and delivery nurses. Concept analysis. The Walker and Avant method of concept analysis was applied to 56 articles. The characteristics, antecedents, and consequences of psychological trauma in labour and delivery nurses were identified. Peer-reviewed articles in English from CINAHL, PubMed and Google Scholar were reviewed on July 2023. The characteristics of psychological trauma in labour and delivery nurses are overwhelming distress, intrusive symptoms, avoidance and numbing behaviours, hypervigilance or hyperarousal, emotional dysregulation, cognitive distortions, and interpersonal challenges. The antecedents are exposure to one or more of the following nurse-specific traumas: natural or person-made disasters, historical role limitations, second victim situations, secondary trauma, system-mediated or over-medicalized care, insufficient resources, or workplace incivility. The consequences are disruptions in mental health, diminished physical health, alterations in relationships, and variable work performance. Labour and delivery nurses experience unique causes of psychological trauma due to their practice environment and patient population. The consequences of labour and delivery nurses' psychological trauma extend beyond individual health and impact the quality of patient care and organizational capacity. Furthermore, research is needed to inform education, support and policy measures to mitigate harm effectively. WHAT PROBLEM DID THE STUDY ADDRESS?: Nurse-specific trauma theory has not been applied to the unique labour and delivery environment with a high incidence of patient trauma. WHAT WERE THE MAIN FINDINGS?: Multiple causes of trauma in the perinatal context have created a pervasive yet largely preventable issue. WHERE AND ON WHOM WILL THE RESEARCH HAVE AN IMPACT?: This research will impact labour and delivery nurses, their leadership, and their patients. No patient or public contribution.

Étude longitudinale des changements éprouvés par les civils exposés aux attentats de novembre 2015 à Paris

IntroductionFollowing the attacks of November 13, 2015, Santé Publique France set up an epidemiological survey. A first phase was carried out in 2016 then repeated in 2020, in order to understand the post-traumatic impact of the attacks. The survey consisted of closed and open-ended questions. We present here the analysis of the answers to the following open-ended questions: “Would you say that the attacks that your experienced has changed you in any way? Could you explain how?” We compare the answers given in 2016 and 2020. ObjectiveTo understand the individual impact of terrorist attacks on civilians between 2016 and 2020. MethodBased on a qualitative analysis, we compare the results at two different times and observe the evolution of these responses. The material is composed of short testimonials related to the question of interest and are processed by thematic analysis inspired by grounded theory. We analyze the responses from 2016 and 2020 independently, and then compare the emerging themes. ResultsThe results highlight the presence of symptoms associated with post-traumatic stress disorder, with symptoms of intrusion, persistent avoidance of stimuli associated with the traumatic event, altered cognition and mood changes in arousal and reactivity related to the traumatic event, significant suffering, and sometimes dissociative elements. Five years after the attacks, disorders are still present in some subjects. The most distressed ones present a profile with no projection into the future, living from day to day, sometimes associated with risky behaviors. The meaning of their existence eludes them. Another part of the respondents tries to find meaning in their lives. They are looking for new life projects. The process of transforming their individuality is underway. Finally, for others whose profiles appear in the 2020 testimonials, changes have been made, they have been able to mourn their past life, who they were, and overcome their trauma. They are resilient and, in some cases, show psychic functioning suggestive of post-traumatic growth. ConclusionThe psychological impact of terrorist attacks on civilians is still very much present with important suffering, but some form of adaptation in the form of resilience or even post-traumatic growth is underway for some five years after the November 2015 attacks.

Symptom Severity and Beat-to-Beat Blood Pressure Variability in Patients with Post-Traumatic Stress Disorder (PTSD)

Individuals with post-traumatic stress disorder (PTSD) have an elevated risk of developing cardiovascular disease. Emerging research suggests that blood pressure variability (BPV) may serve as an early indicator for increased cardiovascular disease risk. However, the relationship between post-traumatic stress symptom severity and symptom clusters, and comorbid conditions such as depression, with BPV is unclear. Purpose: The primary objective of this study was to investigate the relationship between the severity of PTSD and depression symptoms, PTSD symptom clusters, and beat-to-beat blood pressure variability (BPV) in a sample of individuals diagnosed with PTSD. We hypothesized that participants with greater PTSD symptom severity would have increased BPV. Methods: Twenty participants (mean age = 46 ± 10 yr; 70% males; 75% African American) with diagnosed PTSD were enrolled. PTSD severity and symptom clusters were assessed via the PTSD Checklist (PCL-5) and depression symptoms were assessed via Beck's Depression Inventory (BDI). Beat-to-beat blood pressure was recorded via finger photoplethysmography for a five-minute duration. BPV indices were calculated as the coeffcient of variation (CV), standard deviation (SD), and average real variability (ARV) for systolic, diastolic, and mean blood pressure. Pearson correlations were conducted to evaluate the association between symptoms and BPV outcomes. Participants were also categorized into two groups based on symptom severity. Independent t-tests were used to compare those with mild to moderate symptoms (n = 7) relative to participants with severe and extreme PTSD symptoms (n = 13). Results: PTSD symptom severity was significantly correlated with depression symptoms (r = 0.83, p < 0.001). However, there were no significant correlations between BPV measures and either PTSD or depression symptoms. We did observe moderate non-significant correlations between the PTSD intrusive symptom cluster and diastolic and mean blood pressure CV (r = 0.33 and r = 0.29, p > 0.05). Similar moderate correlations were observed between depression symptoms and diastolic and mean blood pressure CV (r = 0.31 and r = 0.29, p > 0.05). No significant differences were observed between the two symptom severity groups in terms of systolic, diastolic, and mean blood pressure for CV, SD, and ARV (systolic CV 0.61 ± 0.17 vs. 0.62 ± 0.17 %, p > 0.05, diastolic CV, 0.70 ± 0.06 vs. 0.72 ± 0.16 %, p > 0.05, and mean blood pressure CV 0.63 ± 0.09 vs. 0.65 ± 0.15 %, p > 0.05 for mild to moderate and severe to extreme PTSD symptoms, respectively). Conclusions: Contrary to our hypothesis, those with greater PTSD symptom severity did not have significantly greater BPV. In summary, our data demonstrate that higher PTSD symptoms are not associated with beat-to-beat BPV; however, the moderate correlations suggest that larger studies are needed to determine if PTSD intrusive symptoms and depression symptoms, are related beat-to-beat BPV indices. VA Merit I01-CX001065, and DOD PR210574. M. McGranahan is supported by NIDDK training grant TL1DK129502 and U2CDK129501. This is the full abstract presented at the American Physiology Summit 2024 meeting and is only available in HTML format. There are no additional versions or additional content available for this abstract. Physiology was not involved in the peer review process.

Peritraumatic dissociation and posttraumatic stress symptoms: the moderating role of perceived threat.

Background: Although peritraumatic dissociation (PD) is viewed as a risk factor for posttraumatic stress disorder (PTSD), prospective studies taking into account other well-known risk factors for PTSD have been scarce, and the exploration of potential moderators within the relations between PD and PTSD has been lacking.Objective: Filling this gap, this prospective study explored the moderating role of perceived threat within the relations between PD and PTSD, above and beyond age, gender, education, and early trauma-related symptoms.Method: A convenience sample of 200 Israeli civilians filled out self-report questionnaires during the peritraumatic phase (T1) and one to two months after the posttraumatic phase (T2) of being exposed to rocket attacks.Results: The results showed that perceived threat and PD were associated with early trauma-related symptoms and PTSD symptoms. Moreover, perceived threat moderated the relationship between PD and all PTSD symptom clusters apart from avoidance.Conclusions: The present results suggest that the implications of PD are shaped by levels of perceived threat, so that detriments of PD are evident when the trauma is appraised as being highly threatening. Therefore, early interventions that aim to decrease PD may be beneficial in preventing PTSD symptoms of intrusion, hyper arousal, and negative alterations in mood and cognition, for individuals who perceive traumatic events as highly threatening.

Posttraumatic stress disorder and spousal relationships in natural disaster victims: a longitudinal study

Background Posttraumatic stress disorder (PTSD) symptoms after natural disaster can have a detrimental effect on marital relationships, which may be through parenting-related factor. Aims The study aimed to examine the mechanism underlying the long-term effects of PTSD symptoms on marital satisfaction via coparenting, and its differences between men and women following the Super Typhoon Lekima. Methods Participants were 465 married victims with children. They reported their PTSD, coparenting, and marital satisfaction at three and fifteen months after the tropical cyclone. Results The results showed that for women, only higher negative cognitive and emotional alterations (NCEA) symptoms were associated with lower marital satisfaction through conflict coparenting. For men, higher intrusion, NCEA, and hyperarousal symptoms were associated with marital satisfaction through different coparenting. To be specific, for men, higher intrusion symptoms were associated with lower marital satisfaction via less reprimand coparenting; higher NCEA symptoms were associated with lower marital satisfaction via less integrity coparenting, and associated with higher marital satisfaction via less conflict coparenting; higher hyperarousal symptoms were associated with lower marital satisfaction via more conflict coparenting. Conclusions These findings suggested that the long-term effect of PTSD symptoms on marital satisfaction via coparenting mainly showed for men.

Profiles of Black Emerging Adults Exposure to Racism-Based Police Violence and Associated Mental Health Outcomes.

This study characterizes the profile of Black emerging adults aged 18-29 generated from sociodemographic characteristics and indicators of police contact and exposure to racism-based police violence (RPV), and the relationship between profiles and traumatic stress symptoms. A purposive sample of 300 Black emerging adults was recruited for this exploratory study. Cluster analysis (CA) was performed to generate profiles of this sample. Two distinct profiles emerged from the CA. Cluster 1 is characterized by participants with low rates of police contacts and direct RPV exposure, whereas Cluster 2 consists of participants with higher rates of police contacts and direct RPV exposure. Regression analysis revealed that being in Cluster 2, as opposed to Cluster 1, was associated with increased scores for depression, avoidance, and intrusion symptoms. Findings provide guidance for mental health intervention strategies to combat the psychological impact of RPV exposure for Black emerging adults.

Impact of COVID-19 on posttraumatic stress disorder in ICU survivors: a prospective observational comparative cohort study

BackgroundPosttraumatic stress disorder (PTSD) after a stay in the intensive care unit (ICU) can affect one in five ICU survivors. At the beginning of the coronavirus disease 2019 (COVID-19) pandemic, admission to the ICU for COVID-19 was stressful due to the severity of this disease. This study assessed whether admission to the ICU for COVID-19 was associated with a higher prevalence of PTSD compared with other causes of ICU admission after adjustment for pre-ICU psychological factors.MethodsThis prospective observational comparative cohort study included 31 ICUs. Eligible patients were adult ICU survivors hospitalized during the first wave of COVID-19 pandemic in France, regardless of the reason for admission. The prevalence of presumptive diagnosis of PTSD at 6 months was assessed using the PTSD Checklist for DSM-5 (PCL-5). Sociodemographics, clinical data, history of childhood trauma (Childhood Trauma Questionnaire [CTQ]), and exposure to potentially traumatic events (Life Events Checklist for DSM-5 [LEC-5]) were assessed.ResultsOf the 778 ICU survivors included during the first wave of COVID-19 pandemic in France, 417 and 361 were assigned to the COVID-19 and non-COVID-19 cohorts, respectively. Fourteen (4.9%) and 11 (4.9%), respectively, presented with presumptive diagnosis of PTSD at 6 months (p = 0.976). After adjusting for age, sex, severity score at admission, use of invasive mechanical ventilation, ICU duration, CTQ and LEC-5, COVID-19 status was not associated with presumptive diagnosis of PTSD using the PCL-5. Only female sex was associated with presumptive diagnosis of PTSD. However, COVID-19 patients reported significantly more intrusion and avoidance symptoms than non-COVID patients (39% vs. 29%, p = 0.015 and 27% vs. 19%, p = 0.030), respectively. The median PCL-5 score was higher in the COVID-19 than non-COVID-19 cohort (9 [3, 20] vs. 4 [2, 16], p = 0.034).ConclusionAdmission to the ICU for COVID-19 was not associated with a higher prevalence of PTSD compared with admission for another cause during the first wave of the COVID-19 pandemic in France. However, intrusion and avoidance symptoms were more frequent in COVID-19 patients than in non-COVID-19 patients.Trial Registration: Clinicaltrials.gov Identifier NCT03991611, registered on June 19, 2019.

Differential Indirect Effects of Military Sexual Trauma on Posttraumatic Stress Disorder Symptom Clusters via Past-Year Intimate Partner Violence Experiences.

Women who serve in the military are at high risk for experiencing military sexual trauma (MST) and intimate partner violence (IPV), both of which are associated with symptoms of posttraumatic stress disorder (PTSD). To improve understanding of the psychological effects of experiencing multiple forms of interpersonal violence, it is important to identify the ways in which recent IPV experiences differentially increase the risk of specific PTSD symptom clusters for women with a history of MST. We aimed to identify if past-year IPV experiences mediate the relation between MST experiences and PTSD symptom clusters (i.e., intrusions, avoidance, negative alterations in cognitions/mood, hyperarousal) using structural equation modeling. A mail survey was administered to a sample of US female veterans at two time points 12 months apart. Among 198 participants, 108 women (54.5%) reported MST at Time 1, and 73 women (36.9%) reported IPV experiences in the past year at Time 2. PTSD symptom severity ranged from asymptomatic to beyond the diagnostic cutoff for a probable PTSD diagnosis. Past-year IPV experiences significantly mediated the association between MST history and PTSD avoidance symptoms, and MST history and PTSD negative alterations in cognitive/mood symptoms. No significant mediating effect was found for intrusion symptoms or hyperarousal symptoms. These findings can inform evidence-based practices for appropriate screening, assessment, detection, and intervention, including primary and secondary prevention efforts to instrumentally reduce future experiences of violence for female survivors of interpersonal violence.

Assessment of PTSD and Trauma Symptoms With the MMPI–3 in College Students: Validity and Incremental Utility of the Anxiety Related Experiences (ARX) Scale

Post Traumatic Stress Disorder (PTSD) is heterogeneous in nature, which complicates diagnostic efforts and makes accurate assessment tools critical. The MMPI family of instruments are widely used broadband measures of psychopathology, including trauma symptomology. The MMPI–3’s Anxiety Related Experiences scale (ARX) is an expansion of the MMPI–2–RF Anxiety (AXY) scale which has historically represented the MMPI family’s best measure of trauma symptoms. This study expands research on ARX in 2 samples of college students (n = 332 [PCL–5 Criterion] & n = 58 [CAPS–5 Criterion]) by examining ARX’s incremental, criterion, and classification validity. ARX incrementally predicted PCL–5 total and cluster scores beyond that accounted for by AXY (R 2Δ = .01–.09). ARX accounted for the most unique variance, beyond RCd and RC7, in CAPS-5 interview ratings of intrusion symptoms (R 2Δ = .16). ARX was strongly related to trauma symptomology broadly (r = .42–.58) and demonstrated strong screening ability at T65 (sensitivity = .37–.40; specificity = .91–.92) and stronger diagnostic screening at T75 (sensitivity = .31; specificity = .93). We discuss clinical considerations when using ARX for assessing PTSD.

Trauma-related intrusive memories and anterior hippocampus structural covariance: an ecological momentary assessment study in posttraumatic stress disorder

Trauma-related intrusive memories (TR-IMs) are hallmark symptoms of posttraumatic stress disorder (PTSD), but their neural correlates remain partly unknown. Given its role in autobiographical memory, the hippocampus may play a critical role in TR-IM neurophysiology. The anterior and posterior hippocampi are known to have partially distinct functions, including during retrieval of autobiographical memories. This study aimed to investigate the relationship between TR-IM frequency and the anterior and posterior hippocampi morphology in PTSD. Ninety-three trauma-exposed adults completed daily ecological momentary assessments for fourteen days to capture their TR-IM frequency. Participants then underwent anatomical magnetic resonance imaging to obtain measures of anterior and posterior hippocampal volumes. Partial least squares analysis was applied to identify a structural covariance network that differentiated the anterior and posterior hippocampi. Poisson regression models examined the relationship of TR-IM frequency with anterior and posterior hippocampal volumes and the resulting structural covariance network. Results revealed no significant relationship of TR-IM frequency with hippocampal volumes. However, TR-IM frequency was significantly negatively correlated with the expression of a structural covariance pattern specifically associated with the anterior hippocampus volume. This association remained significant after accounting for the severity of PTSD symptoms other than intrusion symptoms. The network included the bilateral inferior temporal gyri, superior frontal gyri, precuneus, and fusiform gyri. These novel findings indicate that higher TR-IM frequency in individuals with PTSD is associated with lower structural covariance between the anterior hippocampus and other brain regions involved in autobiographical memory, shedding light on the neural correlates underlying this core symptom of PTSD.

Patient journey of civilian adults diagnosed with posttraumatic stress disorder—A chart review study

Objective To assess the journey of individuals from experiencing a traumatic event through onset of symptoms, diagnosis, and treatment of posttraumatic stress disorder (PTSD). Methods Patient- and psychiatrist-level data was collected (02/2022–05/2022) from psychiatrists who treated ≥1 civilian adult diagnosed with PTSD. Eligible charts covered civilian adults diagnosed with PTSD (2016–2020), receiving ≥1 PTSD-related treatment (selective serotonin reuptake inhibitors [SSRIs], serotonin-norepinephrine reuptake inhibitors [SNRIs], atypical antipsychotics [AAs]), and having ≥1 medical visit in the last 12 months. Collected information included clinical and treatment characteristics surrounding the PTSD diagnosis. Results A total of 273 psychiatrists contributed data on 687 patients with PTSD (average age 36.1; 60.4% female). On average, the traumatic event and symptom onset occurred 8.7 years and 6.5 years prior to PTSD diagnosis, respectively. In the 6 months before diagnosis, 88.9% of patients had received a PTSD-related treatment. At time of diagnosis, 87.8% of patients had intrusion symptoms and 78.9% had alterations in cognition/mood; 41.2% had depressive disorder and 38.7% had anxiety. Diagnosis prompted treatment changes for 79.3% of patients, receiving treatment within 1.9 months on average, often with a first-line SSRI as either monotherapy (52.8%) or combination (24.9%). At the end of the 24-month study period, 34.4% of patients achieved psychiatrist-recorded remission. A total of 23.0% of psychiatrists expressed dissatisfaction with approved PTSD treatments, with 88.3% at least somewhat likely to prescribe AAs despite lack of FDA approval. Conclusion PTSD presents heterogeneously, with an extensive journey from trauma to diagnosis with low remission rates and limited treatment options.

Somatic symptoms and insomnia among bereaved parents and siblings eight years after the Utøya terror attack

ABSTRACT Background: Levels of prolonged grief symptoms (PGS) and post-traumatic stress symptoms (PTSS) can be high, many years following bereavement after terror, but knowledge concerning somatic health is scarce. Terrorism is a serious public health challenge, and increased knowledge about long-term somatic symptoms and insomnia is essential for establishing follow-up interventions after terrorism bereavement. Objective: To study the prevalence of somatic symptoms and insomnia and their association with PGS, PTSS, and functional impairment among terrorism-bereaved parents and siblings. Methods: A cross-sectional quantitative study included 122 bereaved individuals from the Utøya terror attack in Norway in 2011. The sample comprised 88 parents and 34 siblings aged 19 years and above (Mage = 49.7 years, SDage = 13.8 years, 59.8% females). The participants completed questionnaires 8 years after the attack assessing somatic symptoms (Children’s Somatic Symptoms Inventory) and insomnia (Bergen Insomnia Scale) along with measures of PGS (Inventory of Complicated Grief), PTSS (Impact of Event Scale–Revised), and functional impairment (Work and Social Adjustment Scale). Results: Fatigue was the most frequently reported somatic symptom (88% of females and 65% of males). Females reported statistically significantly more somatic symptoms than males. In total, 68% of the bereaved individuals scored above the cut-off for insomnia. There were no statistically significant gender differences for insomnia. Female gender, intrusion, and arousal were associated with somatic symptoms. Intrusion and somatic symptoms were associated with insomnia. Somatic symptoms, avoidance, and hyperarousal were associated with functional impairment. Conclusion: Many bereaved parents and siblings report somatic symptoms and insomnia eight years after the terror attack. Somatic symptoms are associated with functional impairment. Long-term follow-up and support after traumatic bereavement should focus on somatic symptoms and insomnia.

Functional correlates of a novel 8-factor model of PTSD in U.S. military veterans: Results from the National Health and Resilience in Veterans Study

Emerging evidence indicates that more nuanced models of posttraumatic stress disorder (PTSD) may better capture the condition's symptom structure. Recent theoretical and empirical work suggest that an 8-factor model of PTSD with separate internally- (e.g. flashbacks) and externally- (e.g. trauma-cue related physiological reactivity) generated intrusive symptom clusters may advance understanding of PTSD and its treatment and course. However, the model's functional and clinical significance still requires evaluation. To this end, we analyzed data from the National Health and Resilience in Veterans Study, a nationally representative sample of 3847 trauma-exposed U.S. military veterans. Multivariable regressions were performed to assess the relationship between the 8 PTSD symptom clusters, assessed using the PTSD Checklist for DSM-5, and clinical and functional measures. Results revealed that externally-generated intrusions were associated with higher odds of current depression and anxiety and worse mental, cognitive, and psychosocial functioning. Anhedonia (e.g., loss of interest in enjoyable activities) symptoms were associated with all the correlates tested, while negative affect (e.g., having strong negative feelings such as fear) symptoms were associated with all measures except depression. Avoidance symptoms were associated with lower odds of current anxiety while externalizing behavior symptoms were linked to higher odds of suicidal ideation. Anxious arousal symptoms were associated with lower odds of suicidal ideation but higher odds of PTSD-related impairment/distress, while dysphoric arousal symptoms were associated with higher odds of current depression, PTSD-related impairment/distress and worse mental and cognitive functioning. Results suggest that a more nuanced 8-factor model of PTSD symptoms may help inform understanding of the clinical and functional correlates of this multi-faceted disorder.

Secondary traumatic stress in working nurses studying part time in a bachelor or Master’s nursing program in Croatia: a cross-sectional study

BackgroundNurses are more likely to be exposed to human suffering than other healthcare professionals. Persons exposed to indirect trauma can experience symptoms of posttraumatic stress disorder, symptoms of avoidance, arousal and intrusion. Secondary traumatic stress (STS) occurs when a person hears about the firsthand traumatic experiences of another. This study aimed to explore the prevalence of STS among working nurses enrolled at a university nursing program.MethodsA cross-sectional study was conducted among nurses working in healthcare enrolled in university bachelor’s or Master’s nursing studies at the Catholic University of Croatia in November 2017. Data were collected using the Secondary Traumatic Stress Scale (STSS) and two items from the World Health Organization quality of life brief version (WHOQOL-BREF).ResultsThe study included 151 students; the response rate was 70%. The mean STS score was 38, indicating that the students on average suffered from moderate STS. Half of participating nurses met the criteria for STS. Working nurses enrolled in Master’s studies had lower STS scores than those enrolled into bachelor studies (t = 4.14, df = 149, p < 0.01). The level of STS had a negative correlation with participants’ quality of life assessment (r=-0.392, p < 0.01) and satisfaction with their health (r=-0.387, p < 0.01). We also found a significant positive correlation between subjective assessment of quality of life and satisfaction with personal health (r = 0.432, p < 0.01). We did not find a significant association between the level of STS and sex (r=-0.094) or years of nursing work experience (r=-0.069). Level of STS varied depending on the participants’ workplace, years of experience in that workplace and their work shifts. The highest levels of STS were seen in nurses working in the internal medicine department, those with 10–14 years of work experience in the current workplace, and those who work block shifts (12-hr shift followed by 24-hour shift).ConclusionOver half of working nurses attending university studies had at least moderate STS. Furthermore, STS was negatively associated with participants’ perception of quality of life and satisfaction with their health. Prevention and alleviation interventions could reduce the burden of STS among nurses.

Secondary traumatic stress disorder in police who handle sexual violence cases

Investigation of criminal cases involving officers who have experienced trauma, such as sexual violence against children, has the potential to experience Secondary Traumatic Stress Disorder (STSD). Secondary Traumatic Stress Disorder (STSD) is a stress disorder that can arise from interactions with someone who experienced a traumatic event. Secondary Traumatic Stress Disorder (STSD) can arise due to one of the triggers, namely emotional contagion, where empathy is often involved in handling cases involving women and children. The study examines the forms of emotional contagion, what factors can cause Secondary Traumatic Stress Disorder (STSD), and how to overcome or prevent the onset of Secondary Traumatic Stress Disorder (STSD). The study was conducted on four police officers who were investigators of sexual violence cases against children in the PPA Unit of Malang District Police. The research uses phenomenological qualitative methods with descriptive data results. Data collection was conducted through semi-structured interviews and processed using thematic analysis techniques—data analysis using coding interview results. Data validity using credibility tested, with triangulation techniques of data sources and member checking. This study found that forms of emotional contagion exist in investigators, such as pity, feel sorrow, sadness, crying, and anger. In addition, several symptoms shown by each subject lead to symptoms of Secondary Traumatic Stress Disorder (STSD), namely intrusive, arousal and avoidance symptoms. It was also found that there was a uniqueness in each subject in how to overcome the onset of Secondary Traumatic Stress Disorder (STSD). STSD in the police has the potential to affect the accuracy in investigating the cases they handle, which then affects law enforcement in the community&#x0D; &#x0D; KEY WORDS&#x0D; police officer; sexual violence; secondary traumatic stress disorderr&#x0D; &#x0D; Copyright ©2023. The Authors. Published by Psikoislamika: Jurnal Psikologi dan Psikologi Islam. This is an open access article under the CC BY NO SA. Link: Creative Commons — Attribution-NonCommercial-ShareAlike 4.0 International — CC BY-NC-SA 4.0

Examining distress among Saudi paramedics in responding to traumatic events: A mixed-methods study

IntroductionParamedics are critical in providing timely medical care to injured patients and responding to trauma events. However, they are often exposed to traumatic events such as death, serious injuries, and violence, which can increase their risk of developing mental health disorders. The nature of their work, including uncontrolled environments and frequent exposure to trauma, as well as the severity of the patient's conditions, all contribute to this risk. This study aims to investigate the distress experienced by Saudi paramedics in response to traumatic events. MethodsAn explanatory sequential mixed-methods approach was used to explore the experiences of distress among a sample of paramedics following traumatic events. ResultsThe study found that the participants ranked assaults and road traffic collisions as the most concerning traumatic events. Qualitative analysis of the data revealed several themes related to the participants' experiences, including emotional well-being, violence, road traffic collisions, death, personal limitations, culture, coping strategies, and professional support. ConclusionsThe study highlights the high levels of distress experienced by paramedics in response to road traffic collisions, with intrusion and avoidance symptoms being the most commonly reported.

Revealing the psychopathological pathway linking trauma to post-traumatic stress disorder: longitudinal network approach.

The present study investigated the psychopathological processes of post-traumatic stress disorder (PTSD) following the network approach to psychopathology. The directed acyclic graph model was employed to analyse a large longitudinal data-set of Chinese children and adolescents exposed to a destructive earthquake. It was found that intrusion symptoms were first activated by trauma exposure, and subsequently activated other PTSD symptoms. The data are consistent with the idea that symptoms may form a self-sustaining dynamic network by interacting with each other to promote or maintain the chronicity of PTSD. The findings advance the current understanding about the psychopathological processes of PTSD, and inform further research and clinical practices on post-traumatic psychopathology.

Military music and society during the French wars, 1793–1815

Abstract The French Revolutionary and Napoleonic Wars were experienced by the ears as much as the eyes, yet the auditory dimensions of these conflicts have received limited attention from historians. This article interrogates the reach and reception of military music in wartime Britain and Ireland by drawing on a wealth of evidence from memoirs, diaries, press reports and regimental archives. It demonstrates that military bands provided sought-after entertainment at myriad public events and staged open-air concerts for socially diverse audiences. The article interprets martial music-making as an important civil-military interface and a potent form of cultural propaganda: a means of inculcating patriotism and asserting the sonic supremacy of the established order in a revolutionary age. But it also reveals that military music provoked irritation, controversy and distress, not least by generating noise complaints and exacerbating sectarianism in Ireland. The article concludes by considering the role of British regimental music-making in overseas colonies and foreign theatres of operations, arguing that it functioned as a form of soft power that underpinned imperial authority, aided diplomacy and eased relations with local inhabitants. An intrusive symptom of large-scale military mobilization, martial music shaped civilian attitudes and soundscapes while profoundly influencing broader musical culture.