Long-term Post-traumatic Stress Research Articles

Clinical risk factors of long-term post-traumatic stress symptoms, anxiety, and depression in COVID-19 survivors.

The COVID-19 pandemic has a profound and lasting impact on the mental health of recovered individuals. To investigate the clinical risk factors associated with long-term post-traumatic stress symptoms (PTSS), anxiety, and depression in COVID-19 survivors, demographic information and medical records were collected during February 19 and March 20, 2020. Assessments of PTSS, anxiety, and depressive symptoms were conducted at two months (April to May 2020, Session 1) and two years (April to May 2022, Session 2) post-discharge. Session 1 included 127 survivors who were infected with the early strains of SARS-CoV-2, and 54 of these participants took part in Session 2. PTSS (median: Session 1 = 9, Session 2 = 7; p = 0.522) and depression (median: Session 1 = 5, Session 2 = 4; p = 0.127) remained unchanged over the two years following COVID-19 infection, while anxiety (median: Session 1 = 5, Session 2 = 2; p < 0.001) significantly decreased at the two-year mark. Severe COVID-19 symptoms were consistently identified as significant risk factors for depression at both time points (Session 1: dyspnea [beta = -0.268, p = 0.016], nausea or vomiting [beta = 0.239, p = 0.031]; Session 2: headache [beta = 0.414, p = 0.014]). They also emerged as risk factors for PTSS and anxiety at the two-month mark (PTSS: cough [beta = -0.334, p = 0.002]; anxiety: continued oxygen therapy [beta = 0.343, p = 0.002], cough [beta = -0.267, p = 0.013]). At the two-year mark, blood sample characteristics were identified as risk factors for PTSS (albumin: beta = 0.455, p = 0.010), anxiety (total bilirubin: beta = 0.440, p = 0.013), and depression (total bilirubin: beta = 0.386, p = 0.021). Mann-Whitney U-tests showed that female survivors had higher anxiety (p = 0.012) and depression (p = 0.046) levels than males at the two-month mark. The sample size was relatively small, and further investigation is needed to determine whether our findings can be directly applied to other samples, including those involving different variants of SARS-CoV-2. Our study may highlight the differences between short-term and long-term clinical risk factors for PTSS, anxiety, and depression in COVID-19 survivors. The identified predictors could provide valuable insights for tailoring interventions to improve the PTSS, anxiety, and depression outcomes at different stages of recovery in COVID-19 survivors.

Long-term post-traumatic stress symptoms in COVID-19 survivors and its risk factors: a two-year longitudinal cohort study

The COVID-19 pandemic has led to widespread mental health problems, necessitating the investigation of longitudinal mental health changes, associated risk factors, and neural mechanisms in survivors. We recorded demographics, mental health, social support, and potential exposures in survivors at 3 months (n = 189), 6 months (n = 47), and 2 years (n = 69) post-discharge and collected brain imaging data at the second timepoint. Control groups included non-COVID-19 locals (3 months: n = 188, 6 months: n = 42, 2 years: n = 71). Results indicated that female survivors exhibited higher post-traumatic stress symptoms (PTSS) and depression levels than female controls for up to 2 years, along with higher anxiety level for up to 6 months. Male survivors had higher PTSS, depression, and anxiety levels than male controls at 2 months. Moreover, COVID-related trauma and low social support were risk factors for PTSS and negative emotions in survivors. Neuroimaging revealed increased amygdala activity in male survivors and correlations between hippocampus activity and depression symptoms as well as between right hippocampus activity and social support. Our study emphasized the importance of monitoring mental wellness in COVID-19 survivors and underscored the crucial role of social support in mitigating mental health problems.

LONG-TERM QUALITY OF LIFE AND POSTTRAUMATIC STRESS FOLLOWING CARDIAC SURGERY: A 5-YEAR FOLLOW-UP STUDY.

<h3>Objective</h3> Heart surgery can have a significant negative effect on patients' quality of life (QoL) and may cause long-term posttraumatic stress reactions. We aimed to estimate the longitudinal change and predictors of health-related quality of life (HRQOL) and identify factors associated with posttraumatic stress (PTS) at 5-year follow-up after elective cardiac surgery. <h3>Methods</h3> Single-centre prospective study was conducted after Regional Bioethics Committee approval. Adult patients undergoing elective cardiac surgery at tertiary heart center were enrolled in the study. HRQOL was measured using the Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36) questionnaire before and 5-years after cardiac surgery. PTS was assessed using the International Trauma Questionnaire. To estimate change in eight domains of HRQOL assessment between two measurement points (preoperativelly and 5 years after surgery) we performed statistical analysis using multivariate latent change modeling. <h3>Results</h3> A total of 286 patients were enrolled into the study. At 5-year follow-up 210 patients were contacted and included into final data analysis. Median age was 62.29 [19–84] years, and 70 % were male. 65 % of study participants underwent coronary artery bypass grafting (CABG). All study participants achieved statistically significant (p<0.001) improvement in Physical Functioning (PF) Mental Health (MH), Vitality (VT) and Social Functioning (SF) domains of HRQOL assessment. No significant shift was observed in General Health (GH) (p=0.067), Bodily Pain (BP) (p=0.248) and composite scores of Role Problems (RP (p=0.686)) and Emotional Problems (RE (p=0.169)) domains 5 years after surgery. Significant gender effects were found on mean levels of GH (βintercept=0.17, p=0.003), PF (βintercept=0.19, p<0.001), BP (βintercept=0.19, p<0.001), MH (βintercept=0.14, p=0.006), VT (βintercept=0.24, p<0.001) and SF (βintercept=0.11, p=0.019), indicating higher scores of these HRQOL domains before heart surgery in men, compared to women. There were no differences in the moderating effects of age, dyslipidemia, hypertension, reduced EF and higher EuroScore II. Patients undergoing valve and combined surgery reported a significant increase in GH, while this change was not observed in the CABG group. In total, 4 (1.9%) patients met the diagnostic criteria for cardiac surgery-related PTSD at 5-year follow-up. <h3>Conclusions</h3> There was an improvement in HRQOL five years after cardiac surgery. Lower rates of all SF-36 domains before surgery, valve and combined surgery were associated with more signifficant HRQOL improvement. Female gender was associated with lower scores in HRQOL before heart surgery, and poorer improvement of physical functioning in comparison to male patients. The incidence of PTSD was 1,9 % in a sample of cardiac patients at 5-year post cardiac surgery.

Psychological Attachment Orientation and Long-Term Posttraumatic Stress Symptoms Among Family Members of ICU Patients.

OBJECTIVES:To determine the degree to which an ICU patient’s family member having an “anxious” psychologic attachment orientation is a risk factor for developing long-term posttraumatic stress disorder (PTSD) symptoms following patient ICU discharge or death.DESIGN:Prospective cohort study.SETTING:Single academic neuroscience ICU from November 2017 to September 2020.PARTICIPANTS:Consecutively enrolled sample of family members, one for each ICU patient with a minimum length of stay of 24 hours.INTERVENTIONS:None.MEASUREMENTS AND MAIN RESULTS:Near time of ICU discharge or patient death, we determined each participant’s psychologic attachment orientation as anxious versus nonanxious via a brief standard survey tool, the Relationship Questionnaire, and measured other participant and patient characteristics as potential covariates. Six months after discharge or death, each participant completed the Impact of Events Scale-Revised (IES-R) to measure PTSD symptoms, with a score of greater than 24 indicative of clinically significant symptoms. Among 162 total participants, 10 of 27 participants (37.0%) with an anxious attachment orientation reported 6-month PTSD symptoms, compared with 24 of 135 nonanxious participants (17.8%) (relative risk, 2.08; 95% CI, 1.13–3.84; p = 0.02; risk difference 19.2%). In a subsequent univariate analysis of participant and patient covariates, anxious attachment orientation, participant Hispanic ethnicity, prior experience as a care partner of a patient with a disability, and participation in 3 or more formal ICU family meetings were all associated with 6-month PTSD symptoms. In a multiple logistic regression, anxious attachment remained an independent predictor of 6-month PTSD symptoms (odds ratio [OR], 3.64; 95% CI, 1.35–9.77; p = 0.01), as did Hispanic ethnicity (OR, 4.72; 95% CI, 1.34–16.6; p = 0.01) and participation in three or more ICU family meetings (odds ratio, 2.97; 95% CI, 1.14–7.68; p = 0.02).CONCLUSIONS:An anxious psychologic attachment orientation is associated with double the risk of long-term PTSD symptoms among family members of ICU patients. Future interventions designed to decrease risk of adverse psychologic outcomes among ICU families could be initially tested for efficacy amongst those who fall into this high-risk category.

Long-Term Post-traumatic Stress Disorder After Orthopaedic Injury: Prevalence and Risk Factors.

To evaluate the prevalence of post-traumatic stress disorder (PTSD) symptoms in individuals who are further removed from injury (up to 3 years) and to identify injury-specific characteristics that are associated with an increased risk for persistent PTSD symptoms. Cross-sectional, retrospective cohort. Level I trauma center. Two hundred forty-three patients operatively treated for orthopaedic trauma between March 2017 through June 2018. Orthopaedic trauma requiring operative intervention. The primary outcome was score on the PTSD Checklist for the DSM-5 (PCL-5) survey. A score of 31 or higher was considered concerning for PTSD. Forty-nine of 239 respondents (20.5%) scored positive for PTSD. Multivariate analysis demonstrated an increased risk of PTSD for patients with a history of smoking and those who required delayed reoperation (greater than 90 days postoperative). White race and low-energy mechanisms of injury were associated with decreased risk of PTSD. Fracture locations were not associated with a higher likelihood of PTSD. The prevalence of PTSD symptoms in patients up to 3 years after surgery remains higher than the estimated prevalence of PTSD in the general US population. It is similar to previously documented rates of PTSD for patients less than 1 year after injury. Long-term complication requiring reoperation was associated with an increased risk of persistent PTSD symptoms. Orthopaedic providers should be mindful of PTSD symptoms not only in the immediate postoperative period but throughout the treatment course particularly for those with identified PTSD risk factors. Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.

Psychological attachment orientations and long-term post-traumatic stress symptoms among family members of neurointensive care unit patients (2120)

Psychological attachment orientations and long-term post-traumatic stress symptoms among family members of neurointensive care unit patients (2120)

Prevalence and Determinants of Immediate and Long-Term PTSD Consequences of Coronavirus-Related (CoV-1 and CoV-2) Pandemics among Healthcare Professionals: A Systematic Review and Meta-Analysis.

Background: The COVID-19 pandemic continues to rise. In order to control the COVID-19 pandemic, healthcare professionals have been subjected to increased exposure to work stress. In this systematic review, we aimed at investigating the prevalence and determinants of immediate and long-term post-traumatic stress disorder (PTSD) effects on healthcare professionals by the COVID-19 (SARS CoV-2) and SARS-2003 (SARS CoV-1) pandemics. Methods: This systematic review was conducted according to the recommendations of the Protocols for Systemic Review and Meta-Analysis (PRISMA) statement. Only studies reporting the prevalence of PTSD (frequency, percentage) and related risk factors (adjusted odds ratio (OR)) in healthcare professionals (HCPs) during the SARS CoV-2 and SARS CoV-1 pandemics were included. The following databases were screened: Medline, Embase, PsychINFO, and Health Psychosocial Instrument (HaPI). Results: Six of eight studies reported PTSD symptoms among healthcare professionals during the COVID-19 pandemic in China (three), Singapore (one), India (one), and the United States of America (USA) (two), while two studies reported symptoms during the SARS-2003 pandemic in China (one) and Singapore (one). Sample sizes ranged from 263 to 5062 with a combined total of 10,074 participants. All of the studies self-reported the level of exposure to coronaviruses (CoV-1 and CoV-2) and severity of PTSD. Seven studies reported the prevalence of immediate PTSD and determinants, while one study reported delayed-onset PTSD (3 years after CoV-1 pandemic). Determinants of immediate PTSD were reported for the CoV-2 pandemic, while those for long-term PTSD were reported for the CoV-1 pandemic. Conclusions: A comprehensive understanding of the prevalence and determinants of immediate or long-term pandemic PTSD for healthcare workers can improve prevention, diagnosis, and management. Rigorous research measuring the prevalence of PTSD and its associated risk factors (adjusted OR) for the CoV-2 pandemic are envisaged. Although strategies to resolve immediate PTSD are key, long-term PTSD must not be overlooked.

Psychological burden of covid-19 health crisis on health professionals and interventions to minimize the effect: what has history already taught us?

Health professionals have been at the frontline of the health service since the outbreak of covid-19, responding promptly to diagnose, support and treat infected patients. World Health Organization (WHO) has already praised their contribution and their essential role in controlling this disease. Some of the main concerns of covid-19's impact to health service staff include work overload, exhaustion, and high risk of self-infection or transmission to family members. Moreover, during the pandemic, caregivers' mental health inevitably becomes vulnerable, with salient stress and anxiety-related symptoms. Uncertainty, fear of contagion, guilt, hopelessness, stigmatization and, in some cases, long-term post-traumatic stress disorder (PTSD) are few of the potential effects posed by this outbreak on health workers. In this review, lessons learnt from previous global crises or pandemics on the psychological impact of health workers are presented. History could potentially provide essential information on how to best manage, support and optimize our approach to this highly appreciated and much needed group of professionals. Targeted and prompt interventions could reduce the psychological strain of health professionals, thus, further improving provided patient care. Covid-19 is an on-going health crisis and this work, even though generated by limited existing data, could be used to inform governments and/or institutions and lead on decisions and changes in current guidelines.

Forecasting individual risk for long-term Posttraumatic Stress Disorder in emergency medical settings using biomedical data: A machine learning multicenter cohort study

The necessary requirement of a traumatic event preceding the development of Posttraumatic Stress Disorder, theoretically allows for administering preventive and early interventions in the early aftermath of such events. Machine learning models including biomedical data to forecast PTSD outcome after trauma are highly promising for detection of individuals most in need of such interventions. In the current study, machine learning was applied on biomedical data collected within 48 h post-trauma to forecast individual risk for long-term PTSD, using a multinominal approach including the full spectrum of common PTSD symptom courses within one prognostic model for the first time. N = 417 patients (37.2% females; mean age 46.09 ± 15.88) admitted with (suspected) serious injury to two urban Academic Level-1 Trauma Centers were included. Routinely collected biomedical information (endocrine measures, vital signs, pharmacotherapy, demographics, injury and trauma characteristics) upon ED admission and subsequent 48 h was used. Cross-validated multi-nominal classification of longitudinal self-reported symptom severity (IES-R) over 12 months and bimodal classification of clinician-rated PTSD diagnosis (CAPS-IV) at 12 months post-trauma was performed using extreme Gradient Boosting and evaluated on hold-out sets. SHapley Additive exPlanations (SHAP) values were used to explain the derived models in human-interpretable form.Good prediction of longitudinal PTSD symptom trajectories (multiclass AUC = 0.89) and clinician-rated PTSD at 12 months (AUC = 0.89) was achieved. Most relevant prognostic variables to forecast both multinominal and dichotomous PTSD outcomes included acute endocrine and psychophysiological measures and hospital-prescribed pharmacotherapy.Thus, individual risk for long-term PTSD was accurately forecasted from biomedical information routinely collected within 48 h post-trauma. These results facilitate future targeted preventive interventions by enabling future early risk detection and provide further insights into the complex etiology of PTSD.

Polygenic prediction of PTSD trajectories in 9/11 responders.

Genetics hold promise of predicting long-term post-traumatic stress disorder (PTSD) outcomes following trauma. The aim of the current study was to test whether six hypothesized polygenic risk scores (PRSs) developed to capture genetic vulnerability to psychiatric conditions prospectively predict PTSD onset, severity, and 18-year course after trauma exposure. Participants were 1490 responders to the World Trade Center (WTC) disaster (mean age at 9/11 = 38.81 years, s.d. = 8.20; 93.5% male; 23.8% lifetime WTC-related PTSD diagnosis). Prospective longitudinal data on WTC-related PTSD symptoms were obtained from electronic medical records and modelled as PTSD trajectories using growth mixture model analysis. Independent regression models tested whether six hypothesized psychiatric PRSs (PTSD-PRS, Re-experiencing-PRS, Generalized Anxiety-PRS, Schizophrenia-PRS, Depression-PRS, and Neuroticism-PRS) are predictive of WTC-PTSD outcomes: lifetime diagnoses, average symptom severity, and 18-year symptom trajectory. All analyses were adjusted for population stratification, 9/11 exposure severity, and multiple testing. Depression-PRS predicted PTSD diagnostic status (OR 1.37, CI 1.17-1.61, adjusted p = 0.001). All PRSs, except PTSD-PRS, significantly predicted average PTSD symptoms (β = 0.06-0.10, adjusted p < 0.05). Re-experiencing-PRS, Generalized Anxiety-PRS and Schizophrenia-PRS predicted the high severity PTSD trajectory class (ORs 1.21-1.28, adjusted p < 0.05). Finally, PRSs prediction was independent of 9/11 exposure severity and jointly accounted for 3.7 times more variance in PTSD symptoms than the exposure severity. Psychiatric PRSs prospectively predicted WTC-related PTSD lifetime diagnosis, average symptom severity, and 18-year trajectory in responders to 9/11 disaster. Jointly, PRSs were more predictive of subsequent PTSD than the exposure severity. In the future, PRSs may help identify at-risk responders who might benefit from targeted prevention approaches.

43.3 MENTAL HEALTH IN CHILDREN AND ADOLESCENTS EXPOSED TO THE 2017 AND/OR 2018 WILDFIRES IN NORTHERN CALIFORNIA

Beginning in 2017, unprecedentedly large wildfires erupted and spread rapidly into urban areas of California, causing enormous devastation of property and life and triggering a rise in demand for community mental health services. Compared with respiratory impacts of wildfires, little has been written on mental health, although disaster survivors have been shown to exhibit long-term posttraumatic stress symptoms. This study addresses behavioral changes in children and adolescents affected by recent wildfires.

Assessment of Factors Associated With Long-term Posttraumatic Stress Symptoms Among 56 388 First Responders After the 2011 Great East Japan Earthquake

First responders are at risk for developing symptoms of posttraumatic stress disorder (PTSD). Little is known about the risk factors for developing PTSD during a years-long period after complex mass disasters. To explore the long-term course of PTSD symptoms and to identify risk factors and their relative association with PTSD among first responders dispatched to the 2011 Japanese earthquake, tsunami, and nuclear disaster. This 6-year, large, prospective cohort study was part of a continuous longitudinal study of Japan Ground Self-Defense Force first responders. The data were collected at 1, 6, 12, 24, 36, 48, 60, and 72 months after mission completion from 2011 to 2017. Of approximately 70 000 eligible participants, 56 388 were enrolled in this study. Data were analyzed from 2017 to 2020. Stress exposures owing to personal or professional disaster experience (eg, duties with body recovery or radiation exposure risk) and working conditions (eg, deployment length, postdeployment overtime work). The Impact of Event Scale-Revised score assessed PTSD symptoms; scores of at least 25 were defined as probable PTSD. Cox proportional hazards regression models assessed the risk factors for incidence of probable PTSD. Among the 56 388 participants, 97.1% were men, and the median age at enrollment was 34 (range, 18-63) years. A probable PTSD rate was 2.7% at 1 month and showed a downward trend in the first year and a subsequent plateau. The cumulative incidence of probable PTSD was 6.75%. The severity of PTSD symptoms demonstrated a high degree of rank-order stability over time. Rather than professional disaster experience, sociodemographic factors and working conditions were independently associated with the incidence of probable PTSD: personal experience of the disaster (hazard ratio [HR], 1.96; 95% CI, 1.72-2.24), deployment length of at least 3 months (HR vs <1 month, 1.75; 95% CI, 1.52-2.02), increased age (HR for ≥46 vs ≤25 years, 2.28; 95% CI, 1.79-2.92), and postdeployment overtime work of at least 3 months (HR vs little to none, 1.61; 95% CI, 1.39-1.87). Given these findings, in the future, first responders' PTSD symptoms might be mitigated by shortening deployment length, avoiding postdeployment overtime work, and paying special attention to the needs of personnel with personal experience of the disaster or older age. Efforts to alleviate responders' initial symptoms will be required.

Post-traumatic stress symptoms in hematopoietic stem cell transplant (HCT) recipients.

7505 Background: Patients admitted for HCT, an intensive and potentially curative therapy for hematologic malignancies, experience a prolonged, isolating hospitalization and endure substantial physical and psychological symptom burden. However, data are limited regarding long-term post-traumatic stress (PTSD) in HCT survivors and its risk factors. Methods: We conducted a secondary analysis examining longitudinal data from 250 patients who underwent autologous and allogenic HCT. We used the Post-Traumatic Stress Checklist (PTSD-CL) to assess for PTSD symptoms at six months post-HCT. We used the Functional Assessment of Cancer Therapy—Bone Marrow Transplant (FACT-BMT), and the Hospital Anxiety and Depression Scale to assess quality of life (QOL), depression, and anxiety symptoms at the time of admission for HCT, at week-2 during hospitalization, and at six months post-HCT. We used multivariate regression models to assess factors associated with PTSD symptoms, modeling QOL, depression, and anxiety symptoms separately given their collinearity. Results: The mean age was 56.3 (SD = 13.3). The rate of clinically significant PTSD symptoms at six months post-HCT was 18.9% and these patients experienced hypervigilance (92.3%), avoidance (92.3%), and intrusion (76.9%) symptoms. Among patients without clinically significant PTSD symptoms, 24.5% and 13.7% had clinically significant hypervigilance and avoidance symptoms, respectively. Lower QOL at time of HCT admission (B = -0.04, P = 0.004), and being single (B = -3.35, P = 0.027) were associated with higher PTSD symptoms at six months post-HCT. Higher anxiety at time of HCT admission (B = 1.34, P &lt; 0.001), change in anxiety during HCT hospitalization (B = 0.59, P = 0.006), and being single (B = -3.50, P = 0.017), were associated with higher PTSD symptoms at six months. In a separate model, younger age (B = -0.13, P = 0.017), being single (B = -3.58, P = 0.018), and higher baseline depression symptoms were also associated with higher PTSD symptoms at six months (B = 0.97, P &lt; 0.001). Conclusions: Approximately one fifth of patients undergoing HCT experienced clinically significant PTSD symptoms at six months post-transplant. Patients’ baseline QOL and psychological symptoms emerged as important predictors of their risk for PTSD at six months post-HCT. Thus, interventions to prevent and treat PTSD symptoms in HCT recipients are clearly warranted.

Efficacy and cultural appropriateness of psychosocial interventions for paediatric burn patients and caregivers: a systematic review

BackgroundPaediatric burns are highly painful and traumatising injuries that are overrepresented among Aboriginal and Torres Strait Islander people. Paediatric burn patients’ pain remains poorly managed by pharmacological interventions, leading to increased anxiety, distress, and trauma in patients and their caregivers. Non-pharmacological psychosocial interventions have been suggested as effective in reducing pain and psychological morbidities among paediatric burn patients and their caregivers; however, their degree of effectiveness and appropriateness for Aboriginal and Torres Strait Islander people is unclear.MethodsA non-date restricted systematic review was conducted through four databases. Studies published in English assessing psychosocial interventions on paediatric burn patients’ physical pain along with theirs and/or their caregiver’s anxiety, distress, or trauma symptoms were identified and included in this review. Included studies were assessed for their ability to reduce one of the outcomes of interests and for their reflection of Aboriginal and Torres Strait Islander peoples’ perspectives of health.ResultsOf the 3178 identified references, 17 were eligible. These include distraction based techniques (n = 8), hypnosis/familiar imagery (n = 2), therapeutic approaches (n = 4), and patient preparation/procedural control (n = 3). Distraction techniques incorporating procedural preparation reduced pain, while discharge preparation and increased ‘patient control’ reduced patient and caregiver anxiety; and internet based Cognitive Behaviour Therapy reduced short-term but not long-term post-traumatic stress symptoms. No interventions reflected Aboriginal and Torres Strait Islander peoples’ perspectives of health; and few targeted caregivers or focused on reducing their symptoms.ConclusionsThe development and assessment of psychosocial interventions to appropriately meet the needs of Aboriginal and Torres Strait Islander paediatric burn patients is required.

Long-term posttraumatic stress disorder in mine workers after a coalmining disaster

Background: A coalmine disaster has occurred in Turkey on 13 May 2014, which caused the death of 301 miners. Objective: This study aimed to determine the prevalence of posttraumatic stress disorder (PTSD) symptoms and the risk factors for PTSD among mine workers, 2 years after the coalmining disaster. Methods: This was a cross-sectional survey conducted between June 2016 and July 2016 among mine workers who were the employees of either the mine where the accident occurred or three other mines in the same area. Sociodemographic data form and PTSD Symptom-Scale Self-Report (PSS-SR) were used to collect data. Results: 672 mine workers participated in the study. At the time of the accident, 23.7% (n = 159) of them were in the mine where the accident occurred. The mean score on total PSS-SR was 4.27 (SD: ±4.49). Eighteen (2.7%) participants screened positive for PTSD. Logistic regression analysis revealed the significant risk factors for PTSD are: being single/divorced/widowed, having a chronic disease, having a family history of psychiatric illness and previously experiencing traumatic events more than one. Discussion: Coalmining workers have considerably high prevalence rate of PTSD symptoms after a coalmining disaster. Assessing PTSD and associated risks is important for preventive mental health services.

Short and Long-Term Parental Posttraumatic Stress After a Child\u2019s Accident: Prevalence and Associated Factors

Studies on the long-term prevalence of parental posttraumatic stress symptoms (PTSS) following child accidental injury are scarce, and findings on risk factors vary. In this follow-up study (T2, n = 69) we determined the prevalence of parental PTSS 2–4 years after accidental injury of their child, compared with 3 months after the accident (T1, n = 135). Additionally, we examined the association between parental and child factors and PTSS severity. Children were 8–18 years old at the time of the accident. Parent and child PTSS was assessed by self-report. Other data were retrieved from medical records and a telephone interview. Parental PTSS was 9.6% at T1 and 5.8% at T2. Acute parental stress as measured within 2 weeks of the child’s accident was significantly associated with parental PTSS severity (T1 and T2), as was the child’s hospitalization of more than 1 day at T1 and the child’s permanent physical impairment at T2. To prevent adverse long-term psychological consequences we recommend identifying and monitoring parents at risk and offering them timely treatment.

Post-Traumatic Growth Following Exposure to Memorial Reports of the 5.12 Wenchuan Earthquake: The Moderating Roles of Self-Esteem and Long-Term PTSD Symptoms.

Media exposure during a traumatic event has been found to be associated with negative psychological consequences. However, the post-disaster role of the mass media and the possible positive psychological consequences of media exposure has received less attention. In the present study, we hypothesized that exposure to memorial media reports would lead to improved post-traumatic growth (PTG). Further, we evaluated the moderating role of self-esteem and long-term post-traumatic stress disorder (PTSD) symptoms in the relationship between media exposure and PTG. Using a cross-sectional design, we surveyed individuals (N = 1000, mean age = 45.62, 43.5% male) who were recruited from disaster-affected communities ten years after the 5.12 Wenchuan earthquake which was the largest country-level trauma in the past three decades. Results revealed that individuals with lower self-esteem or lower PTSD symptoms would have higher psychological growth with greater exposure to memorial news reports. For individuals who reported having both high levels of self-esteem and PTSD symptoms, the relationship between media exposure and PTG was negative. These findings help present trauma in a new light, particularly regarding the rapid and instantaneous new coverage of the digital age. This study also has multi-disciplinary, cross-cultural, and clinical implications for the fields of psychology, public health, and communications.

Novel Risk Factors for Posttraumatic Stress Disorder Symptoms in Family Members of Acute Respiratory Distress Syndrome Survivors.

Family members of ICU survivors report long-term psychologic symptoms of posttraumatic stress disorder. We describe patient- and family-member risk factors for posttraumatic stress disorder symptoms among family members of survivors of acute respiratory distress syndrome. Prospective cohort study of family members of acute respiratory distress syndrome survivors. Single tertiary care center in Seattle, Washington. From 2010 to 2015, we assembled an inception cohort of adult acute respiratory distress syndrome survivors who identified family members involved in ICU and post-ICU care. One-hundred sixty-two family members enrolled in the study, corresponding to 120 patients. None. Family members were assessed for self-reported psychologic symptoms 6 months after patient discharge using the Posttraumatic Stress Disorder Checklist-Civilian Version, the Patient Health Questionnaire 9-item depression scale, and the Generalized Anxiety Disorder 7-item scale. The primary outcome was posttraumatic stress disorder symptoms, and secondary outcomes were symptoms of depression and anxiety. We used clustered multivariable logistic regression to identify patient- and family-member risk factors for psychologic symptoms. Posttraumatic stress disorder symptoms were present in 31% (95% CI, 24-39%) of family participants. Family member risk factors for posttraumatic stress disorder symptoms included preexisting mental health disorders (adjusted odds ratio, 3.22; 95% CI, 1.42-7.31), recent personal experience of serious physical illness (adjusted odds ratio, 3.07; 95% CI, 1.40-6.75), and female gender (adjusted odds ratio, 5.18; 95% CI, 1.74-15.4). Family members of previously healthy patients (Charlson index of zero) had higher frequency of posttraumatic stress disorder symptoms (adjusted odds ratio, 2.25; 95% CI, 1.06-4.77). Markers of patient illness severity were not associated with family posttraumatic stress disorder symptoms. The prevalence of long-term posttraumatic stress disorder symptoms among family members of acute respiratory distress syndrome survivors is high. Family members with preexisting mental health disorders, recent experiences of serious physical illness, and family members of previously healthy patients are at increased risk for posttraumatic stress disorder symptoms.

Long-term quality of life and posttraumatic stress following elective cardiac surgery: preliminary findings of a 5-year follow-up study.

Heart surgery is a major stressful event that can have a significant negative effect on patients' quality of life (QoL) and may cause long-term posttraumatic stress reactions. The aim of this pilot study was to estimate the longitudinal change and predictors of health-related quality of life (HRQOL) dynamics and identify factors associated with PTS at 5-year follow-up (T2) after elective cardiac surgery and associations with pre-surgery (T1) QoL. Single-centre prospective study was conducted after Regional Bioethics Committee approval. Adult consecutive patients undergoing elective cardiac surgery were included. HRQOL was measured using the Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36) questionnaire before (T1) and 5-years after (T2) cardiac surgery. Posttraumatic stress was assessed using the International Trauma Questionnaire. The pilot study revealed a significant positive change at 5-year follow-up in several domains of SF-36: physical functioning (PF), energy/fatigue (E/F), and social functioning (SF). Prolonged postoperative hospital stay was associated with change in SF (p < 0.01), E/F (p < 0.05) and emotional well-being (p < 0.05). The percentage of patients that had the posttraumatic stress disorder (PTSD) at T2 was 12.2%. Posttraumatic stress symptoms were associated with longer hospitalization after surgery (p < 0.01). HRQOL improved from baseline to five years postoperatively. Patients with lower preoperative HRQOL scores tended to have a more significant improvement of HRQOL five years after surgery. A prolonged postoperative hospital stay had a negative impact on postoperative social functioning, energy/fatigue, and emotional well-being. Increased levels of PTSD were found in cardiac surgery patients following five years after the surgery.

Persons injured in the 2011 terror attacks in Norway - Relationship between post-traumatic stress symptoms, emotional distress, fatigue, sleep, and pain outcomes, and medical and psychosocial factors

Purpose: The main aim was to assess long-term post-traumatic stress symptoms, emotional distress, fatigue, sleep disturbances and pain in individuals hospitalized with physical injuries after two terror attacks in Oslo in 2011, approximately three years after the events. A secondary aim was to explore the relationship between these outcomes and medical and psychosocial factors.Materials and methods: Thirty of 43 potential persons participated. Injury characteristics were collected from medical charts. Level of post-traumatic stress, emotional distress, fatigue, sleep disturbances and pain was assessed and the association with injury severity, resilience, optimism, neuroticism and extroversion, and perceived access to social support was explored.Results: Nine of 30 met criteria for full or partial PTSD, and 14 of 30 displayed clinical levels of emotional distress. Fifteen reported moderate to severe fatigue, and 16 said sleep disturbances affected their daily life. Twelve indicated that pain affected daily activities and work ability, and 15 that pain affected their quality of life. I Resilience, optimism, neuroticism, and perceived social support, were associated with outcomes, but injury severity was not. When controlling for pain, many of the psychosocial variables failed to reach significance.Conclusions: Injury severity was not associated with outcomes. On the other hand, psychosocial factors were, but seemed to be influenced by pain.Implications for rehabilitationPersons who have obtained physical injuries under extreme psychological conditions such as terror, are at high risk of poor long-term outcomes, and will often be in need of comprehensive interdisciplinary rehabilitation services.Psychological outcomes are not associated with severity of physical injury, but premorbid and current psychological variables such as resilience, optimism, personality, and access to social support are highly associated with long-term outcome.Longstanding pain seems to diminish or weaken the role of protective psychological factors and should be addressed in the rehabilitation context.