Levels Of Posttraumatic Stress Symptoms Research Articles

The association between perceive social support and post-traumatic stress disorder symptoms among medical staff in Hubei, China: a chain mediating effect of resilience and positive coping

BackgroundEvidence suggests that PTSD symptoms following public health emergencies are influenced by many factors. The aim of this study was to investigate the relationship between perceived social support and Post-traumatic stress disorder symptoms and to explore the chain-mediated role of resilience and positive coping style, among medical staff in Hubei Province, China, during a public health emergency.MethodsConvenience sampling was used to select medical staff from two general hospitals in Hubei Province in July 2022 for this study. A total of 2,751 medical staff were included in the study. Multidimensional Scale of Perceived Social Support, 10- itemConnor- Davidson resilience scale, Simplified Coping Style Questionnaire and The Post-traumatic stress disorder Checklist for DSM-5 were used to assess the levels of perceived social support, resilience, coping style and Post-traumatic stress disorder symptoms of medical staff two years after the public health emergency. Statistical descriptions were conducted using SPSS, and a structural equation model was established using AMOS to analyze the chain-mediated roles of resilience and positive coping style between perceived social support and Post-traumatic stress disorder symptoms.ResultsStructural equation modeling results showed a standardized total effect of perceived social support on Post-traumatic stress disorder symptoms of -0.416 (95%CI [-0.456, -0.374], P < 0.001). Resilience mediated the effect of perceived social support and Post-traumatic stress disorder, with an indirect effect of -0.016 ( 95%CI [0.031, 0.001], P = 0.038). Positive coping mediated the effect of perceived social support and Post-traumatic stress disorder, with an indirect effect of -0.024 (95%CI [-0.035, -0.014], P < 0.001). Resilience and positive coping style chain-mediated between perceived social support and Post-traumatic stress disorder symptoms, mediating 17.1% of the total effect.ConclusionPerceived social support has significant direct and indirect effects on Post-traumatic stress disorder symptoms and resilience. In addition, positive coping style act as chain mediators between perceived social support and Post-traumatic stress disorder symptoms. We suggest that strengthening perceived social support for medical staff can enhance their resilience, encouraging them to adopt positive coping, which in turn reduces the level of post-traumatic stress symptoms among medical staff following public health emergencies.

COVID-19 Personal Experiences and Posttraumatic Stress in National Guard Service Members.

The National Guard (NG) was an important component of the U.S. emergency response for the coronavirus (COVID-19) pandemic. Understanding how the personal COVID-19 experiences of NG members may be associated with posttraumatic stress symptoms (PTSS) and disorder (PTSD) can inform approaches to identifying and sustaining service members' mental health. We surveyed 3,993 NG service members (75% Army; 79% enlisted; 33% 30-39 years old; 81% male) during the pandemic. Forty-six percent of participants were activated in response to COVID-19. Surveys were administered between August and December 2020. We defined personal COVID-19 experiences as having COVID-19, a family member(s) having COVID-19, and/or having a close relationship with someone who died from COVID-19. In addition, using a 4-item form of the PTSD Checklist for DSM-5 (PCL-5), current posttraumatic stress symptoms (PTSS) and probable PTSD were assessed. Linear and logistic regression analyses were conducted to examine the relationship of COVID-19 experiences to PTSS and probable PTSD, respectively. Approximately 32% of participants reported at least one personal COVID-19 experience. Univariable linear regression analyses indicated that NG service members who had a personal COVID-19 experience reported more PTSS than those with no personal experience (B = 0.53, SE = 0.12, P < .001). After adjusting for demographics and service-related characteristics, having a personal COVID-19 experience continued to be associated with higher PTSS (B = 0.48, SE = 0.12, P < .001). When examining the relationships of distinct types of personal COVID-19 experiences to PTSS and PTSD together in multivariable models, those who had a close relationship with someone who died from COVID-19 had higher levels of PTSS (B = 1.31, SE = 0.22, P < .001) and were almost 3 times more likely to have PTSD (OR = 2.94[95%CI = 1.93-4.47], P < .001). Personal COVID-19 experiences are associated with increased PTSS and PTSD risk in NG service members. Such knowledge may aid in selection of service members for activation and identifying those in need of care.

Posttraumatic growth among Israeli female combat veterans: The mediating roles of posttraumatic stress symptoms and self-efficacy.

Posttraumatic growth (PTG) is a possible common reaction to exposure to potentially traumatic events (PTEs) during military service. However, knowledge about correlates of PTG among female combat veterans is sparse. This study examines associations between combat exposure, posttraumatic stress symptoms (PTSS), general self-efficacy (GSE), and PTG among Israeli female veterans. This is a cross-sectional studyA volunteer sample of female Israeli combat veterans (n=616) and non-combat veterans (n=484) responded to self-report questionnaires. Combat veterans reported higher levels of combat exposure, PTSS, GSE, and PTG, as compared to non-combat veterans. Among combat veterans, combat exposure and GSE were associated with greater PTG. Importantly, PTSS and GSE mediated the link between combat exposure and PTG. The study's findings are among the first to report about possible psychological growth outcomes among Israeli combat veterans. Clinicians treating female veterans coping with combat trauma should be aware of the heterogeneity of reactions to military service challenges and the importance of enhancing veterans' GSE to facilitate PTG.

The role of rumination and metamemory beliefs in posttraumatic growth and posttraumatic stress

The risk of developing posttraumatic stress symptoms following exposure to traumatic events is well documented, however, emerging research also lends support to the potential development of growth in some people. Rumination and memory have been identified as important factors in post-trauma outcomes, yet, current research in this area is limited, particularly in the context of a multidimensional view of rumination (i.e., intrusive and deliberate rumination) and metamemory beliefs. This study explored the association between rumination styles, beliefs about memory, and posttraumatic stress symptoms and posttraumatic growth. Participants (N = 151) who experienced a traumatic event completed relevant measures online. Path analysis showed that intrusive rumination was significantly related to higher levels of posttraumatic stress symptoms (β = 0.19, p < 0.01), while deliberate rumination was related to higher levels of both posttraumatic growth (β = .52, p < 0.001) and posttraumatic stress symptoms (β = 0.15, p < 0.05). Additionally, negative beliefs about memory were significantly related to higher posttraumatic stress symptoms (β = 0.48, p < 0.001). No significant associations were found for positive beliefs about memory. The findings suggest that rumination may be understood as multidimensional, incorporating both adaptive and maladaptive processes. Further, the present study contributes to the limited literature concerning metamemory beliefs and may provide an increased understanding of factors contributing to stress or growth.

Posttraumatic stress symptoms in recovery from concussion

ABSTRACT Background Previous literature suggests that lingering concussion symptoms may be influenced by psychological factors. The relationship of posttraumatic stress symptoms (PTSS) during recovery with pre-existing/injury related factors and concussion symptomology is not fully understood. Identification of factors contributing to symptoms of posttraumatic stress may provide guidance to improve treatment following concussion. Method This study included 287 participants (Male 40.42%, n = 116; Female 59.58%, n = 171) aged 13–75 years diagnosed with a recent concussion at one of the North Texas Concussion Registry (ConTex) specialty concussion clinic sites. Preinjury emotional history, injury related factors, and emotional state at time of initial evaluation were analyzed as predictors of post-traumatic stress symptoms (PCL-5) during recovery. Results Sixty-one percent of participants endorsed at least one PTSS. Correlations were found between initial Sport Concussion Assessment Tool 5Ⓡ (SCAT5) total emotional symptom severity and screening measures for anxiety (GAD-7; r = .453, p < .001) and depression (PHQ-8; r = .550, p < .001) symptom scores. Of the measures from the initial visit included in the multiple regression model predicting severity of PTSS at follow-up (R2 = 0.554, β < .001), three measures predicted PTSS severity: initial SCAT5 total emotional symptom severity (β = 0.565, p < .001), PHQ-8 score (β =.166, p = .009), and GAD-7 score (β = 0.119, p = .044). Conclusions Symptoms of anxiety and depression along with specific SCAT5 emotional symptoms present at the time of initial evaluation may serve to predict overall level of PTSS and increased risk for PTSS during recovery. PTSS may be another dimension of response to injury and concussion recovery, with a large percentage of individuals endorsing at least one PTSS. Clinicians can utilize brief assessments such as the SCAT5 at the time of initial clinical evaluation to identify those at risk for PTSS following concussion.

Psychometric Evaluation of the Traumatic Grief Inventory-Self Report Plus (TGI-SR+) in Chinese Bereaved People.

The Traumatic Grief Inventory-Self Report Plus (TGI-SR+) measures the most recent prolonged grief disorder (PGD) symptom sets defined in the 11th edition of the International Statistical of Diseases and Related Health Problems (ICD-11) and the text revision of the fifth edition of the Diagnostical and Statistical Manual of Mental Disorders (DSM-5-TR). However, the TGI-SR+ has not yet been translated and validated in Chinese. This study aims to evaluate the psychometric properties of the Chinese translation of the TGI-SR+. We examined the Chinese TGI-SR+'s factor structure, internal consistency, convergent validity, discriminant validity, known-groups validity, and optimal clinical cut-off scores in 443 Chinese bereaved adults. Confirmatory factor analyses showed that the two-factor models showed the best fit for the Chinese TGI-SR+ items assessing ICD-11 and DSM-5-TR prolonged grief symptoms. Items assessing ICD-11 and DSM-5-TR prolonged grief symptoms demonstrated good internal consistency. Associations of TGI-SR+ scores with symptom levels of prolonged grief (assessed by the International Prolonged Grief Disorder Scale), posttraumatic stress, anxiety, and depression supported convergent and discriminant validity. Associations with background/loss-related variables provided evidence for known-groups validity. Cut-off points for probable ICD-11 PGD (liberal scoring rule), probable ICD-11 PGD (conservative scoring rule), and probable DSM-5-TR PGD were ≥67, ≥75, and ≥68, respectively. The Chinese TGI-SR+ appears to be a reliable and valid measure to assess prolonged grief symptoms per ICD-11 and DSM-5-TR among Chinese bereaved adults.

Latent trajectories of anxiety and depression among women during subsequent pregnancy following pregnancy loss.

To determine the longitudinal trajectories of anxiety and depression among pregnant women who have experienced pregnancy loss, and to explore the association between post-traumatic stress symptoms (PTSS) related to pregnancy loss and these trajectories. A prospective longitudinal study. Between October 2022 and August 2023, pregnant women with a history of pregnancy loss were recruited from four hospitals in Guangdong Province, China. Eligible participants were screened for PTSS related to pregnancy loss upon enrolment. Anxiety and depression symptoms were assessed in early, mid and late pregnancy using the Pregnancy-related Anxiety Questionnaire-Revised 2 and the Patient Health Questionnaire-9, respectively. Latent class growth analysis was employed to categorize anxiety and depression trajectories, and multinomial logistic regression analysis was conducted to examine the association between PTSS and these trajectories. Of the 388 participants included in the analysis, 158 individuals (40.7%) reported high PTSS scores. The best-fitting models identified three trajectories for both anxiety and depression: low (anxiety: 35.6%, depression: 48.7%), moderate (anxiety: 44.8%, depression: 40.5%) and high (anxiety: 19.6%, depression: 10.8%). Pregnant women with high PTSS levels were significantly more likely to experience moderate-to-high trajectories of anxiety and depression compared to those with low PTSS levels. Pregnant women who have experienced pregnancy loss exhibit higher incidences of elevated anxiety and depression trajectories. Screening for PTSS and targeted supportive care are recommended to alleviate anxiety and depressive symptoms in this population. This study underscores the importance of early psychological screening and tailored interventions for pregnant women with a history of pregnancy loss. Trauma-informed care should be prioritized to mitigate anxiety and depression trajectories in this vulnerable population. There was no patient or public involvement.

Social support utilization's effect on post-traumatic stress symptoms: a Danish cross-sectional study of 383 ambulance personnel.

Social support is considered an important factor in prevention of mental illness. However, little is known about the association between ambulance personnel's use of multiple types of social support and post-traumatic stress symptoms (PTSS). This study aims to assess if number of used social support types predicts PTSS for ambulance personnel. Apart from assessing the main effect of social support utilization, we were interested in investigating if social support utilization moderated the effect of frequency of critical events on PTSS. A total of 383 ambulance personnel completed a survey consisting of validated questionnaires. Hierarchical multiple linear regression analyses were performed to assess the association between frequency of traumatic exposure and utilization of social support and PTSS as outcome variable. Higher number of utilized social support types was associated with higher levels of PTSS (β = 0.15, p <.001). When serving as a moderator of the association between frequency of exposure to critical incidents and PTSS, social support utilization had a significant and positive interaction effect (β = 0.26, p = .049). 307 participants had used 2 or 3 types of informal support during the past year, whereas 81 had used 2 or 3 types of formal support. To our knowledge, this is the first study investigating the relationship between utilization of multiple, concurrent social support types and PTSS. This study suggests that to understand the effects of social support among ambulance personnel, it is necessary to assess the utilization of multiple concurrent support types, contributing factors to social support use, and different patterns of social support utilization that constitutes professional life in ambulance work.

Self-blame, posttraumatic stress, and cardiovascular reactivity among sexual trauma survivors.

Although trauma is closely linked with hyperarousal and cardiovascular health, little research has examined the effects of posttraumatic stress symptoms (PTSS) on cardiovascular reactivity to trauma reminders among sexual trauma survivors. One type of negative appraisal after trauma, self-blame, is common after sexual trauma, but its relation to cardiovascular reactivity is unknown. The present study aimed to examine the influence of both PTSS and self-blame on blood pressure and heart rate (HR) reactivity to a trauma reminder. Cardiovascular reactivity was measured before, during, and after a laboratory-based sexual trauma reminder among 72 young adult women who have experienced sexual trauma. Higher PTSS predicted lower diastolic blood pressure (DBP) reactivity during the trauma reminder. Higher levels of self-blame predicted higher HR and systolic blood pressure (SBP) reactivity during and after the trauma reminder. Overall, these findings suggest that survivors of sexual trauma with higher levels of PTSS experience a blunting reaction of DBP when exposed to trauma reminders, as opposed to a more typical cardiovascular stress reaction that may elevate and then extinguish to baseline levels. Meanwhile, individuals with higher levels of self-blame have heightened cardiovascular SBP and HR responses during trauma reminders that do not return to baseline levels, perhaps due to self-blame leading individuals to be more 'on guard' to prevent future threats. Longitudinal studies are needed to explore the potential long-term cardiovascular impacts of heightened self-blame and PTSS and their associated cardiovascular reactivity patterns.

Parental warmth attenuates the impact of low and moderate levels of violence exposure on trauma symptoms among women with substance use disorders

Women with substance use disorders (SUD) have high rates of violence exposure and are at greater risk for developing post-traumatic stress symptoms (PTSS) than women without SUD. However, there is limited research on the factors that protect against the development of PTSS in response to violence exposure among women with SUD. Positive early attachment relationships may be one factor that protects against the development of PTSS in adulthood. We examined the bonding experience of parental warmth during childhood as a potential moderator in the relationship between violence exposure and PTSS in adulthood. Using ordinary least squares (OLS) regression, and assessing moderation using the SPSS PROCESS macro, we examined whether parental warmth moderated the impact of violence exposure on PTSS among women with SUD. Greater violence exposure was associated with higher levels of PTSS, while higher levels of parental warmth were associated with lower levels of PTSS. Parental warmth attenuated the effects of violence exposure on PTSS at low and moderate levels of violence exposure, but not at high levels of violence exposure. High violence exposure may overwhelm the potential for positive relational experiences to buffer against the development of PTSS. Results from this study suggest the importance of early intervention and support for early caregiving relationships as part of the prevention of mental health disorders across the life course.

COVID-19 Symptoms and Mental Health Outcomes among Italian Healthcare Workers: A Latent Class Analysis.

The COVID-19 pandemic has led to long-lasting consequences for workers leading to what has been termed a "psychological pandemic". Some categories, such as healthcare workers (HCWs), are considered high risk due to factors such as increased exposure and stressful working conditions. In this study, we investigate whether levels of posttraumatic stress symptoms and COVID-19-related fear (IES-6 and PSI-4) are associated with illness severity in a sample of 318 infected HCWs in Italy. To investigate the presence of different profiles of COVID-19 severity, Latent Class Analysis (LCA) was performed based on 11 symptoms. Differences in the IES-6 and PSI-4 scores across the latent classes were compared using the non-parametric Kruskal-Wallis (KW) test with Dunn's multiple comparison post hoc testing. Our analyses show that the LCA identified three classes of symptoms, reflecting no/low, mild and severe symptoms. The classes include vomiting, confusion, conjunctivitis, diarrhea, dyspnea, headache, ageusia, fever, anosmia, osteo muscle articular pain and asthenia. We found that HCWs who experienced more intense symptoms reported significantly higher IES-6 and PSI-4 scores. Moreover, we found gender-related differences in IES-6 and PSI-4 scores as females exhibited higher levels than males. Indeed, these findings are useful for developing health prevention and emergency management programs.

Feasibility of a trauma-focused internet- and mobile-based intervention for youth with posttraumatic stress symptoms

ABSTRACT Background: Many youth with posttraumatic stress symptoms (PTSS) do not receive evidence-based care. Internet- and Mobile-Based Interventions (IMIs) comprising evidence-based trauma-focused components can address this gap, but research is scarce. Thus, we investigated the feasibility of a trauma-focused IMI for youth with PTSS. Methods: In a one-arm non-randomized prospective proof-of-concept study, 32 youths aged 15–21 years with clinically relevant PTSS (CATS ≥ 21) received access to a trauma-focused IMI with therapist guidance, comprising nine sessions on an eHealth platform accessible via web-browser. We used a feasibility framework assessing recruitment capability, sample characteristics, data collection, satisfaction, acceptability, study management abilities, safety aspects, and efficacy of the IMI in PTSS severity and related outcomes. Self-rated assessments took place pre-, mid-, post-intervention and at 3-month follow-up and clinician-rated assessments at baseline and post-intervention. Results: The sample mainly consisted of young adult females with interpersonal trauma and high PTSS levels (CATS, M = 31.63, SD = 7.64). The IMI sessions were found useful and comprehensible, whereas feasibility of trauma processing was perceived as difficult. Around one-third of participants (31%) completed the IMI’s eight core sessions. The study completer analysis showed a significant reduction with large effects in self-rated PTSS at post-treatment [t(21) = 4.27; p < .001; d = 0.88] and follow-up [t(18) = 3.83; p = .001; d = 0.84], and clinician-rated PTSD severity at post-treatment [t(21) = 4.52; p < .001; d = 0.93]. The intention-to-treat analysis indicated significant reductions for PTSS at post-treatment and follow-up with large effect sizes (d = −0.97– –1.02). All participants experienced at least one negative effect, with the most common being the resurfacing of unpleasant memories (n = 17/22, 77%). Conclusion: The study reached highly burdened young adults. The IMI was accepted in terms of usefulness and comprehensibility but many youths did not complete all sessions. Exploration of strategies to improve adherence in trauma-focused IMIs for youth is warranted, alongside the evaluation of the IMI's efficacy in a subsequent randomized controlled trial.

A pilot study of a brief and scalable psychosocial intervention for children and adolescents following disasters.

Following disaster exposure, a significant proportion of children/adolescents will develop levels of post-traumatic stress symptoms (PTSS) that do not meet diagnostic threshold for PTSD, but which cause ongoing distress. This paper describes the development and pilot testing of a brief, scalable, psychosocial intervention. SOLAR-Kids/Teens has been designed to be delivered by non-mental health professionals ('coaches') to children/adolescents experiencing moderate levels of PTSS following disasters. An international collaboration of experts developed The Skills fOr Life Adjustment and Resilience (SOLAR) for Kids and Teens programs. The programs were piloted-using a pre-post mixed methods design-with 10 children and adolescents (8-18 years), with the aims of examining the feasibility of the program's delivery model as well as the program's potential usefulness. The pilot data indicated that after 1 day of training and with ongoing supervision, the SOLAR program was safe and feasible for coaches to deliver to children/adolescents experiencing PTSS. Coaches reported increased knowledge (p = .001), confidence (p = .001) and skills (p = .006). The programs were acceptable to coaches, children/adolescents and parents. Parents and children/adolescents reported reductions in trauma and anxiety symptoms from pre- to post-treatment, with moderate to large effect sizes. The preliminary findings demonstrate that the SOLAR-Kids/Teens program is feasible, acceptable and safe to be delivered by trained non-mental health professionals to children and adolescents experiencing PTSS and anxiety following disaster exposure. Randomized controlled trials are required to evaluate the efficacy of the SOLAR-Kids/Teens programs.

The relationship between traumatic exposure and pain perception in children: the moderating role of posttraumatic symptoms.

Adverse childhood experiences (ACEs) affect approximately half of all children worldwide. These experiences have been linked to increased pain sensitivity in adulthood and a higher likelihood of developing severe chronic pain. However, most studies have assessed the effects of ACEs retrospectively, long after they occurred, leaving room for other factors to influence the observed outcomes. We investigated, for the first time, the association between ACEs and concurrent pain perception among young children who live in a conflict zone and are consistently exposed to potentially traumatic experiences. Participants were 60 elementary school children (ages 8-11 years) living in conflict regions (n = 39) or nonconflict regions (n = 21). Posttraumatic stress symptom (PTSS) severity, traumatic exposure, pressure pain threshold (PPT), and mechanical detection threshold (MDT) were measured. Trauma-exposed children had significantly lower PPT than did controls, but MDT was similar across groups. Pressure pain threshold correlated positively with proximity to the conflict zone and inversely with traumatic exposure magnitude and PTSS severity. In addition, PTSSs moderated the relationship between repeated traumatic exposure and PPT. Children with higher PTSS severity displayed pain hypersensitivity regardless of their traumatic exposure level, whereas in children with lower PTSS severity, greater traumatic exposure correlated with pain hypersensitivity. The results suggest that ACEs among children lead to concurrent pain hypersensitivity and distress and may put them at elevated risk of chronic pain early in life. In addition, our findings emphasize the need for identifying children with various PTSS levels to provide tailored interventions and mitigate the long-term negative effects of ACEs.

Mental health in Chilean higher education students during the COVID-19 pandemic: A longitudinal study.

The COVID-19 pandemic has required important changes in the lifestyles and quality of life of higher education students, generating emotional distress. This study sought to evaluate a predictive model of emotional distress and positive mental health through measures of posttraumatic stress symptoms (PTSS) and posttraumatic growth (PTG) in Chilean higher education students during the pandemic. To this end, 502 students (67.8% female), aged 18-44 years, were surveyed at two time points during the pandemic, separated by 6 months. Potential predictors included emotional regulation strategies, perceived social support, sociodemographic characteristics, factors related to the pandemic, and students' experiences related to online classes. Findings indicated that PTSS levels were generally stable across the two time points, but PTG levels increased. In addition, emotional regulation strategies (suppression, cognitive reappraisal), perceived social support, and female gender predicted both PTSS and PTG 6 months later; students' number of hours of screen time for school also influenced PTG. Findings enhance understanding of the processes contributing to PTSS and PTG in higher education students. The need to improve quality of life and mental health in higher education students, including individual- and institutional-level strategies, is discussed. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

The contributions of social network support and reciprocity to posttraumatic stress symptoms across time among parents and caregivers impacted by the ABC Day Care Center fire in Hermosillo, Mexico.

In 2009, a fire occurred in the ABC Day Care Center in Hermosillo, Mexico, that killed and injured many children who were in attendance that day. This study investigated the association between the posttraumatic stress symptoms (PTSS) of socially connected parents and caregivers whose children were affected by the fire. Parents and caregivers of the children who were in attendance the day of the fire were interviewed 8-11 months and 20-23 months postfire. Linear network autocorrelation modeling was used to test for autocorrelations of the outcome variable count of PTSS within different configurations of the network of caregivers. No significant network effects appeared in models from the first interview period, but effects did appear in the second period, specifically in the three models in which network ties consisted of "receive informational support" (.220), "give and receive emotional support" (.167), and "give and receive both informational and emotional support" (.213). The findings suggest that in these three network configurations, as relationships grew in strength from the first interview to the second, the level of one's own PTSS was more comparable to the level of PTSS of one's social connections. Two theoretical mechanisms that may explain this result are homophily and social influence.

The Role of Post-Traumatic Stress Symptoms and Post Migration Life Difficulties for Future Aspirations of Iraqi and Syrian Asylum Seekers

The majority of asylum seekers experience some kind of traumatic events before or during their flight and their challenging experiences do not end after resettlement. Still, they need to envision and build their future life in the host country. Moreover, asylum seekers’ future aspirations need to be differentiated from the satisfaction of essential needs. We (1) measured future aspirations (FA); (2) explored whether FA and post-migration life difficulties (PMLD) differ between asylum seekers with high and low levels of post-traumatic stress symptoms (PTSS); and (3) examined whether PTSS, PMLD, gender, age, and length of stay are associated with different types of FA. In total, 139 Iraqi and Syrian asylum seekers (55 female, 83 male) aged 18 to 67 years ( M = 34.03, SD = 10.35) participated. A four-factor structure of FA was confirmed by confirmatory factor analysis (CFA). Participants with high levels of post-traumatic stress symptoms reported higher levels of PMLD and lower levels of FA related to their home country. FA related to the host country and FA related to occupation were predicted by lower levels of post-traumatic stress symptoms, while future aspirations related to the home country were predicted by higher levels of PMLD. Results indicate that asylum seekers who experienced more traumatic events before they migrated are more reluctant to return to these places in the future. Treating the psychological impairments of this highly vulnerable group and relaxing the manifold structural barriers are crucial to foster their construction of a future life.

Critical incidents and post-traumatic stress symptoms among experienced registered nurses during the COVID-19 pandemic: A cross-sectional study

BackgroundRegistered nurses working on the frontline during the COVID-19 pandemic encountered significant challenges, including exposure to critical incidents. Critical incidents refer to sudden unexpected clinical events that surpass an individual's ability to cope, leading to considerable psychological distress, which could potentially result in the development of post-traumatic stress disorder symptoms. Research has shown a high prevalence of post-traumatic stress disorder symptoms among healthcare workers, particularly those in close contact with COVID-19 patients. ObjectiveTo assess the levels of post-traumatic stress symptoms among registered nurses in relation to exposure to working conditions during the COVID-19 pandemic, such as how much their work was affected by the pandemic, re-deployment, working hours hindering sufficient recovery between shifts and critical incidents. DesignCross sectional study. Setting(s)The registered nurses working in multiple health care services covering all 21 geographic regions in Sweden. ParticipantsA total of 1,923 registered nurses, who are part of a Swedish national cohort and have been followed since their nursing education, were invited to participate in a survey in late September 2021 (15 to 19 years post graduation). MethodsThe data were analyzed using descriptive statistics, unpaired t-tests, and one-way analysis of variance. Cohen's d was employed to quantify differences in mean levels between subgroups. ResultsThe response rate were 56.5 %. Over 50 % of experienced registered nurses reported significant disruptions to their work environments. In total, 85 % of registered nurses were exposed to at least one critical incident in their work during the pandemic, with 60 % facing organisational changes and nearly 50 % experiencing emotionally distressing situations. The exposure to work situations involving critical incidents consistently demonstrated strong associations with higher levels of post-traumatic stress disorder symptoms compared to those not exposed, with effect sizes ranging from moderate to high. ConclusionsThis study underscores the profound impact that working conditions, such as redeployment and exposure to critical incidents, have on the mental health of registered nurses. We offer valuable insights into registered nurses’ pandemic-related challenges, highlighting the need for support and interventions to prevent and manage critical incidents, ultimately promoting their well-being. We also highlight the significance of thorough workforce readiness planning for future pandemics and other challenging health care scenarios, such as staff shortage.

Patient characteristics associated with posttraumatic stress symptoms in intensive care unit survivors during a one-year follow-up: A multicenter study

BackgroundIntensive care unit (ICU) patients are at risk of suffering from posttraumatic stress symptoms (PTSS) after ICU survival. ObjectivesTo describe the prevalence of high levels of PTSS the first year after ICU admission. Further, to identify specific combinations of patient characteristics (latent classes based on pre-ICU data, demographics, and clinical characteristics), and to investigate possible associations among these classes and PTSS at 3, 6, and 12 months after ICU admission. MethodsSelf-reported PTSS were measured with Impact of Event Scale-Revised (IES-R). PTSS and possible predictive factors (pre-ICU data, demographics, and clinical characteristics) were analyzed using descriptive statistics, latent class analysis, and linear mixed model for repeated measures. ResultsHigh PTSS levels (IES-R ≥ 33) were reported by 14.9 % (95 % confidence interval [CI] [10.0; 21.1]), 16.7 % (95 % CI [11.5; 23.1]), and 18.4 % (95 % CI [12.9; 25.0]) of patients (sample 1, n = 174) at 3, 6, and 12 months, respectively. Three latent classes were identified (sample 2, n = 417). PTSS were significantly associated with class 2 (male with longer hospital stay) at 6 months and class 3 (age≥70, lower level of education, higher Simplified Acute Physiology Score, being mechanically ventilated) at all three measurement times. ConclusionsThe prevalence of high levels of PTSS is the greatest 12 months after ICU admission. Health professionals can use this information to be aware of specific groups of ICU patients reporting PTSS during the first year and follow up on these.

A longitudinal investigation of caregiving and adolescent post-traumatic stress symptoms during COVID-19: evidence for high resting RSA as a susceptibility factor.

Post-traumatic stress symptoms (PTSS) were the most frequently reported mental health concern for youth during COVID-19, yet variations in youth's PTSS responses warrant empirical consideration. Features of the caregiving environment influence youth's responses to environmental stressors, and youth's parasympathetic nervous system regulation may qualify the magnitude and/or direction of these effects. This prospective investigation evaluated diathesis stress and differential susceptibility models of caregiving and parasympathetic influences on youth's PTSS responses to COVID-19. Participants were 225 caregiver-youth dyads (youth 49.8% female at birth; 88.4% non-white) followed from childhood through adolescence and COVID-19. Youth's resting respiratory sinus arrhythmia (RSA; Mage = 6.11, s.d. = 0.21), caregiving features (i.e. attachment security [youth Mage = 12.24, s.d. = 0.35] and caregiver internalizing psychopathology [caregiver Mage = 39.29, s.d. = 6.78]) were assessed pre-pandemic. Youth's PTSS was assessed one year prior to the US COVID-19 pandemic (Mage = 14.24, s.d. = 0.50) and during the spring of 2020 at the height of the pandemic (Mage = 15.23, s.d. = 0.57). Youth's PTSS increased during COVID-19. Youth with relatively high resting RSA evidenced the lowest PTSS when their caregiving environment featured high attachment security or low caregiver internalizing problems, but the highest PTSS when their caregiving environment featured low attachment security or high caregiver internalizing problems. In contrast, PTSS levels of youth with relatively low or average resting RSA did not differ significantly depending on attachment security or caregiver internalizing. Results are consistent with a differential susceptibility hypothesis, wherein relatively high resting RSA conferred heightened sensitivity to caregiving environments in a for-better-and-for-worse manner during COVID-19.