Partial Posttraumatic Stress Disorder Research Articles

Differences in predictive factors for post-traumatic stress disorder encompassing partial PTSD and full PTSD: a cross-sectional study among individuals exposed to the November 13, 2015 Paris attacks.

When faced with a surge of physically injured individuals, especially following a traumatic event like an attack, frontline practitioners prioritize early triage. Detecting potential psychological injuries soon after such events remains challenging. Some individuals might develop post-traumatic stress disorder (PTSD) according to DSM-V criteria. Others may exhibit PTSD symptoms without meeting full diagnostic criteria, termed partial or sub-syndromal PTSD, a less-explored area in literature. This study aims to identify predictive factors for both full and partial PTSD. In a cohort of victims of the 2015 Paris attacks, multinomial logistic regressions explored predictive factors for partial or full PTSD status 8 to 18 months post-attacks. Analyses considered pre, peri, and posttraumatic factors chosen from literature review and univariate analysis within each group. Within the cohort, 50 individuals showed no signs of PTSD, 35 experienced partial PTSD, and 30 presented with full PTSD. After logistic regression, risk factors associated with full PTSD included a history of trauma (OR = 1.30, CI [1.02-1.66], p < 0.05), the intensity of peri-traumatic physical reactions (OR = 1.22, CI [1.09-1.36], p < 0.001), the difficulties in suppressing intrusive thoughts (OR = 1.11, CI [1.02-1.21], p < 0.013). Only the intensity of peri-traumatic physical reactions emerged as a risk factor for partial PTSD (OR = 1.13, [CI 1.02-1.24], p < 0.001). This study revealed that a history of trauma, the intensity of peri-traumatic physical reactions (e.g., tachycardia, trembling, flushes, numbness.), and the difficulties in suppressing intrusive thoughts constitute risk factors for the development of full PTSD. Moreover, the study identified that only the intensity of peri-traumatic physical reactions emerged as a risk factor for partial PTSD. These findings seem to underscore the significance of peri-traumatic experiences in influencing the development of post-traumatic stress symptoms. This study emphasizes the significance of examining peri-traumatic reactions in PTSD development, suggesting its potential as a straightforward screening tool for post-traumatic stress disorder. It also underscores the influence of prior traumatic experiences, before de novo traumatization, in shaping vulnerability to PTSD and illuminates the crucial role of compromised control of intrusive thoughts that could perpetuate PTSD.

Investigating the Neural Correlates of Partial PTSD: A Systematic Literature Review

Background: Partial PTSD (PPTSD) describes the presence of clinically significant trauma symptoms that do not meet the diagnostic criteria of posttraumatic stress disorder (PTSD). This study examines the neural correlates of PPTSD by drawing a symptomatic overlap between Generalised Anxiety Disorder (GAD) and Major Depressive Disorder (MDD). Methods: Literature databases included Google Scholar, PubMed and Mendeley. Following a preliminary screening, six exclusion criteria (Inadequate data, No neural correlates, Comorbidities, Lifetime prevalence of PPTSD, Inconsistent results, Age criteria) were applied. The reference lists of all selected papers were also screened. Results: A total of sixty-three papers were reviewed and critically appraised using the Joanna Briggs Inventory. This study examined the neural networks and dysregulations associated with Partial Post-Traumatic Stress Disorder (PPTSD), shedding light on the intricate interplay of brain regions contributing to the spectrum of PPTSD symptoms. Five key neural networks and regions that play a central role in PPTSD were identified. The Default Mode Network (DMN), Salience Network (SN), Executive Control Network (ECN), Emotion Regulation Network, and the Hypothalamic-Pituitary-Adrenal (HPA) Axis. Along with which the role of the hippocampus in conjunction with these networks was also highlighted. Conclusion: These findings emphasise the complex neural landscape underlying PPTSD, with the interplay between these networks and regions contributing to a wide range of neural dynamics. Further research, including neuroimaging and neuromodulatory studies, is needed to explore these interactions in greater depth. Understanding these neural mechanisms is crucial for developing effective interventions and treatments for PPTSD and related disorders.

Autonomic nervous system function before and after trauma-focused psychotherapy in youth with (partial) posttraumatic stress disorder

While trauma-focused psychotherapies have been shown effective in youth with PTSD, the relationship between treatment response and alterations in the autonomic nervous system (ANS) associated with PTSD, remains incompletely understood. During neutral and personalized trauma script imagery heart rate (HR), pre-ejection period (PEP) and respiratory sinus arrhythmia (RSA) were recorded in youth aged 8–18 with PTSD or partial PTSD (n = 76) and trauma-exposed controls (TEC) (n = 27) to determine ANS activity and stress reactivity. Within the patient group, 77.6% met the full DSM-IV diagnostic criteria for PTSD, the remaining 22.4% met the criteria for partial PTSD. Youth with (partial) PTSD were subsequently treated with eight sessions of either trauma-focused cognitive behavioral therapy or eye movement desensitization and reprocessing. PTSD severity was assessed using the Clinician-Administered PTSD scale for Children and Adolescents to divide patients into responders and non-responders. Youth with (partial) PTSD relative to TEC had higher overall HR during both neutral and trauma imagery (p = .05). Youth with (partial) PTSD showed RSA decrease during trauma imagery relative to neutral imagery, the reverse of TEC (p = .01). Relative to non-responders, responders demonstrated a significant baseline to posttreatment increase of RSA response to stress only when employing a ≥ 50% response criterion (p = .05) and not with the primary ≥ 30% criterion (p = .12). Our results suggest overall higher HR and sympathetic nervous system activity as well as vagal withdrawal in response to stress in youth with (partial) PTSD and only provide partial support for normalization of the latter with successful trauma-focused psychotherapy.

Croissance post-traumatique et stratégies de coping chez les sapeurs-pompiers civils français

IntroductionOften faced with potentially traumatic critical incidents, firefighters may experience both negative and positive changes. These include full or partial post-traumatic stress disorder, specific coping strategies and possibly post-traumatic growth. For firefighters, these factors might be related, and their experiences may be possibly different depending on the status of the participants (professional vs volunteer firefighters). ObjectiveThe aim of this study is to explore and predict post-traumatic growth, post-traumatic stress disorder and coping strategies in a sample of French professional and volunteer firefighters. MethodA mixed research methodology was used. The Post-traumatic Stress Disorder Checklist, the Post-traumatic Growth Inventory, the Brief-Cope Inventory, and a semi-structured research interview were used with sixteen participants, divided into two equal groups: a group of eight professional firefighters and a group of eight volunteer firefighters. ResultsPost-traumatic growth was predicted at 63.4 % by traumatic symptomatology (altered arousal and reactivity) and by coping strategies (avoidance and positive thoughts). Spiritual changes predicted post-traumatic distress at 24.9 %. Firefighters who were not parents had more post-traumatic growth and positive thoughts than those who had children. There were no statistical difference between the volunteer and professional firefighter groups. Volunteer firefighters felt more vulnerable to critical incidents than professional firefighters because they have access to fewer effective resources. ConclusionPost-traumatic growth among firefighters could be explained by post-traumatic distress and coping strategies. Other factors influencing post-traumatic growth would need to be investigated (coping flexibility, parenting, a sense of self-efficacy).

Experiences of (Potentially) Traumatizing Deployments and Posttraumatic Stress in Police Officers - An Exploratory Survey of Early Career Police Officers

As part of their career police officers are faced with traumatic events on a regular basis and are at a higher risk of developing PTSD compared to the general population. The aim of this study was to examine if and how many early career police officers already experienced potentially traumatizing situations and how many conform to either subsyndromal or complete PTSD criteria. Further subject of interest was if the officers know the concept of psychosocial emergency care for first responders (PSNV-E) and if such support is made use of. N=221 early career police officers were assessed via an online-survey about their posttraumatic stress symptoms. More than half of the participants (n=121) reported having experienced at least one traumatic deployment. PTSD prevalence in this group was at 1.7%, an additional 14.9% showed partial PTSD. One fifth did not know about the PSNV-E concept. Police officers are confronted with a range of extremely stressful events early in their career leading to first symptoms of PTSD in some of them. Early prevention strategies as well as the identification of those affected for secondary prevention is of very high relevance for long term mental health.

Mental health impact of the catastrophic 2023 earthquake on Turkish youth: psychological distress amidst humanitarian crisis

On February 6, 2023, Türkiye was struck by a devastating earthquake with a magnitude of 7.8, a natural disaster of enormous destruction. As a result, many citizens succumbed to mortality, suffered immense physical and psychosocial harm, and the properties of the survivors suffered severe damage. Adolescents and the youth sector in particular are at an increased risk of developing psychiatric disorders1. Hence, policymakers and stakeholders need to pay attention to this understudied sector to prevent and manage health care issues associated with the recent earthquakes. Because of their rapid appearance, ferocity, and devastation, earthquakes exert unequivocal stress events2. Previous studies have demonstrated that posttraumatic stress disorder (PTSD) is frequently linked to earthquakes, which have a significant psychological influence on individuals and hinder their early return to normal activities while prolonging unpleasant emotions3. Moreover, prior traumatic encounters and childhood abuse have a significant impact on the mental health of adolescent survivors3. Recalling fear, triggering memories, or experiencing panic and anxiety is one of the most notable effects of the possibility and persistence of PTSD. These symptoms have a rapid impact on mental health and, according to studies and personal experience, are associated with the initiation and risk of developing PTSD3. In addition, this disorder comprises mood disorders, such as dysthymia and anxiety, with the diagnosis being connected to the existence of PTSD following the earthquake3. The majority of adolescent survivors’ experience intrusive flashbacks and posttrauma ruminations, also known as event-related ruminations, which result from the shaking of beliefs after excruciating occurrences2. Adolescents may experience varying levels of trauma following the earthquake, with one of the most significant elements influencing the intensity being the loss of family members and the damage of homes, which causes a dramatic change in their lives2,3. Adolescent trauma survivors are thought to focus more on the negative aspects of traumatic cues as a result of automatic ruminations that reduce an individual’s ability to avoid them. The most recent earthquake in Türkiye since 1939 had the largest recorded magnitude, and it damaged an area of around 400 km24. The chronicity of adolescent survivors’ mental health and quality of life are impacted by postearthquake difficulties including eviction, destroyed homes, or injuries. These variables are more likely to be subjected to harsher conditions in the aftermath of the traumatic event3. According to a study, those who have experienced partial or full PTSD symptoms for 2 years may continue to experience them for the following 10 years5. The Turkish government faces a serious task in constructing a suitable plan to aid the afflicted youth alongside heal those affected and develop a prosperous generation. In response to the rising prevalence of adolescent mental health issues, the World Health Organization (WHO) is assisting the Turkish government through its regional concept of operations, working in partnership with the Turkish Ministry of Health to provide mental health services throughout all impacted areas4. It is advised to conduct a structured examination of adolescent psychological distress symptoms. This may be achieved by interviewing teenagers, preferably without their parents present to prevent emotional bias and distress disguise. This mediates a secure clinical setting in which to discuss their traumatic experience to receive appropriate care6. Moreover, following the early emergency comeback, children and caregivers will warrant additional specialized trauma healing interventions that will be crucial in assisting youth in maintaining their well-being while also being impacted by the risk and protective factors that came with the Türkiye earthquake7. Offering extensive training for mental health professionals is highly advised, so that the symptoms of PTSD and other disorders are revealed more rapidly, and hence managed more sufficiently6. Not only should face-to-face therapy be offered, but also eHealth methods should be adopted to expand the range of benefited adolescents throughout all regions of Türkiye6. There is a need to break the stigma surrounding mental health, that acts as a barrier preventing individuals from seeking help. Moreover, community and political engagement and improvement of disaster management goals accountability and identifying gaps are essential steps. Through sustained research identification of predictors may help formulate postdisaster relief and rehabilitation efforts to further reduce the psychological distress in such a humanitarian crisis. Ethical approval Not applicable. Sources of funding The authors have not received any financial support for this manuscript. Author’s contribution O.U.: conceptualization, project administration, writing—review and designing. H.A.: reviewing the first draft and revising. J.W.: reviewing and editing. All authors approved the final manuscript and submission. Conflicts of interest disclosure The authors declare that they have no financial conflict of interest with regard to the content of this report. Research registration unique identifying number (UIN) Abubakar Nazir. Guarantor Abubakar Nazir. Data availability statement Not applicable.

Posttraumatic stress disorder and depression after the 2018 Strasbourg Christmas Market terrorist attack: a comparison of exposed and non-exposed police personnel

ABSTRACT Background: Police personnel are among the first responders exposed to terrorist attacks, raising in number in the late decades. Due to their profession, they are also exposed to repetitive violence, increasing their vulnerability to PTSD and depression. Objective: Our study aims at comparing the prevalence of PTSD and depression, and the risk factors associated with these conditions among directly and indirectly exposed versus non-exposed police personnel during the Strasbourg Christmas Market terrorist attack. Method: Three months after the attack, participants completed a survey assessing their sociodemographic characteristics, occupational data, degree of exposure, sleep debt around the event, event centrality (CES), and three mental health conditions: PTSD (PCL-5), depression (PHQ-9), and suicide risk (yes/no questions). Results: A total of 475 police personnel responded to the questionnaire: 263 were exposed to the attack (182 of them directly) and 212 were non-exposed. Among directly exposed participants, the prevalences of partial and complete PTSD were 12.6 and 6.6%, and the prevalence of moderate-to-severe depression was 11.5%. Multivariate analysis revealed that direct exposure was associated with a higher risk of PTSD (OR = 2.98 [1.10–8.12], p = .03). Direct exposure was not associated with a higher risk of depression (OR = 0.40 [0.10–1.10], p = .08). A significant sleep debt after the event was not associated with a higher risk of later PTSD (OR = 2.18 [0.81–5.91], p = .13) but was associated with depression (OR = 7.92 [2.40–26.5], p < .001). A higher event centrality was associated with both PTSD and depression (p < .001). Conclusions: Police personnel directly exposed to the Strasbourg Christmas Market terrorist attack were at higher risk of PTSD but not depression. Efforts to prevent and treat PTSD should focus on directly exposed police personnel. However, general mental health should be monitored for every personnel member.

Post-traumatic stress disorder symptoms among caretakers of COVID 19 and caretakers of non COVID 19 patients: A comparative study

All over the world, the public is being informed about the physical effects of COVID-19 infection and protocols are being made to prevent exposure to the corona virus and manage symptoms of COVID‐19 if they appear. However, the effects of this pandemic on individual’s mental health and behavior have not been studied in detail and are still not known. Efforts are being made to focus on understanding the clinical features, routes of transmission, epidemiology, and management of the COVID‐19 outbreak, there has been very little concern expressed over the effects on one's mental health and on strategies to prevent stress. The aim of this study was to assess the post traumatic stress disorder symptoms among the care takers of COVID-19 patients and care takers of non COVID-19 patients and compare the results to explore the impact of COVID-19 on the mental health of the population associated with the COVID-19 patients. This may help in future in early detecting the post traumatic stress disorder associated with covid-19 or any other pandemic and may help in taking early measures to avoid it and improve the mental health of general population. The study finding revealed that among care takers of covid-19 patients majority of study subjects (93.3%) had complicated PTSD, (6.7%) had Diagnostic PTSD and none of the subjects had Partial PTSD whereas, among care takers of non covid-19 patients majority of study subjects (36.7%) had Partial PTSD, (26.7%) had complicated PTSD, (23.3%) had no PTSD and (13.3%) had diagnostic PTSD. This indicates that the covid-19 had more psychological impact on the care takers than any other life threatening disease. This may be due to fast dissemination of covid-19, more deaths attributed to the pandemic and care takers concern for his/her health. The study concluded that the covid-19 had more psychological impact on the care takers than any other disease conditions. So there is need to improve the strategies to reduce the risk of developing PTSD symptoms in this group of population.

Efficacy of psychological interventions for post-traumatic stress disorder in children and adolescents exposed to single versus multiple traumas: meta-analysis of randomised controlled trials.

Previous meta-analyses of psychotherapies for children and adolescents with post-traumatic stress disorder (PTSD) did not investigate whether treatment efficacy is diminished when patients report multiple (versus single) traumas. To examine whether efficacy of psychological interventions for paediatric PTSD is diminished when patients report multiple (versus single) traumas. We systematically searched PsycInfo, MEDLINE, Web of Science and PTSDpubs on 21 April 2022 and included randomised controlled trials (RCTs) meeting the following criteria: (a) random allocation; (b) all participants presented with partial or full PTSD; (c) PTSD is the primary treatment focus; (d) sample mean age <19 years; (e) sample size n ≥ 20. Trauma frequency was analysed as a dichotomous (single versus ≥2 traumas) and continuous (mean number of exposures) potential moderator of efficacy. Of the 57 eligible RCTs (n = 4295), 51 RCTs were included in quantitative analyses. Relative to passive control conditions, interventions were found effective for single-trauma-related PTSD (Hedges' g = 1.09; 95% CI 0.70-1.48; k = 8 trials) and multiple-trauma-related PTSD (g = 1.11; 95% CI 0.74-1.47; k = 12). Psychotherapies were also more effective than active control conditions in reducing multiple-trauma-related PTSD. Comparison with active control conditions regarding single-event PTSD was not possible owing to scarcity (k = 1) of available trials. Efficacy did not differ with trauma exposure frequency irrespective of its operationalisation and subgroup analyses (e.g. trauma-focused cognitive-behavioural therapy only). The current evidence base suggests that psychological interventions for paediatric PTSD can effectively treat PTSD in populations reporting single and multiple traumas. Future trials for PTSD following single-event trauma need to involve active control conditions.

PTSD and Partial PTSD among First Responders One and Five Years after the Paris Terror Attacks in November 2015

Following the Paris terror attacks in November 2015, a large number of first responders (FR) were mobilized and consequently were at risk of developing posttraumatic stress disorder (PTSD). Based on the ESPA 13 November survey, the objectives of this study were to 1) describe the prevalence of PTSD and partial PTSD in FR five years after the attacks, 2) describe the changes in PTSD and partial PTSD from one to five years after the attacks, and 3) examine factors associated with PTSD and partial PTSD five years after the attacks. Data were collected using an online questionnaire. PTSD and partial PTSD were measured using the Post-Traumatic Stress Disorder Checklist based on the DSM-5 (PCL-5). Gender, age, responder category, education level, exposure, mental health history, history of traumatic events, training, social support, concern about the COVID-19 epidemic, and somatic problems present after the attacks were all analyzed as potential factors associated with PTSD and partial PTSD using multinomial logistic regression. A total of 428 FR were included 5 years after the attacks, of which 258 had participated also 1 year after the attacks. Five years after the attacks, the prevalence of PTSD and partial PTSD were 8.6% and 22%, respectively. Presence of somatic problems after the attacks were associated with PTSD. Involvement in dangerous crime scenes was associated with a higher risk of partial PTSD. No awareness of psychological risks in the context of professional activity through specific training was associated with partial PTSD, in particular among participants aged 45 years or more. To mitigate PTSD for FR, monitoring mental health symptoms, providing mental health education, and providing treatment may be needed for several years after the attacks.

Ten-Year Follow-Up of Earthquake Survivors

Objective: Few earthquake survivor studies extend follow-up beyond 2 years, leaving the long-term course of earthquake-related posttraumatic stress disorder (PTSD) unknown. This 10-year survey re-assessed the 1999 İzmit, Turkey, earthquake survivors. Methods: İzmit earthquake survivors (N = 198), previously assessed for PTSD/partial PTSD at 1–3 months and 18–20 months post-earthquake, were evaluated 10 years post-event from January 2009 through December 2010. A PTSD self-test (Turkish translation) used DSM-IV criteria to characterize full PTSD, “stringent partial PTSD,” “lenient partial PTSD,” or non-PTSD based on symptom type/amount. Results: Full PTSD prevalence decreased from 37% at 1–3 months post-earthquake to 15% at 18–20 months (P < .001), remaining relatively stable (12%) at 10 years (P = .38). Stringent and lenient partial PTSD decreased between 1–3 months and 18–20 months (from 9% to 3% and from 24% to 12%, respectively; P < .001), remaining stable at 10 years (5% and 9%, respectively; P = .43 and P = .89). PTSD was more prevalent at 1–3 months among those who had a close acquaintance harmed, had been evacuated for long periods (> 1 week), or had more children; this was not observed at 10 years (P = .007–.017). Avoidance symptoms 1–3 months post-earthquake were the best predictor for full PTSD at 10 years (P < .001). Delayed-onset PTSD was observed in only 2% of participants. Conclusions: Full and partial PTSD decreased over the first 2 years post-trauma, but remained stable at 10 years, suggesting PTSD symptoms at around 2 years remain stable at 10 years. Background characteristics did not predict PTSD long-term course, but avoidance level did. Delayed-onset PTSD was relatively rare.

Prevalence of post-traumatic stress and tests of metacognition as a PTSD risk marker in patients with coronary heart disease and elevated HADS scores: analysis of data from the PATHWAY RCT's in UK cardiac rehabilitation.

Anxiety and depression in coronary heart disease (CHD) are associated with poorer health outcomes, greater healthcare use and reduced quality of life. Post-traumatic stress symptoms may be a particular concern as they are associated with increased mortality at follow-up. We examined prevalence of PTSD in patients with elevated anxiety/depression scores referred for cardiac rehabilitation (CR) across seven NHS sites in North-West England. We tested a possible mechanism (metacognition) linking CHD to PTSD symptom severity as implicated in the metacognitive model. Data was collected at baseline as part of the NIHR funded PATHWAY trial of metacognitive therapy for anxiety and depression in CHD. Patients (n = 572) with at least mild symptoms of anxiety and depression under routine screening (assessed with the Hospital Anxiety and Depression Scale) and attending CR were eligible for the study. A battery of questionnaires, including assessment of demographic variables, PTSD symptoms (using the IES-R) and metacognitive beliefs was administered prior to random allocation and intervention delivery. Rates of PTSD were high, with 48% of patients meeting threshold for PTSD and a further 15% partial PTSD. All five metacognition subscales were positively associated with PTSD vs. no PTSD, with beliefs about the uncontrollability and danger of worry and beliefs about need to control thoughts being most strongly related. For every unit increase in uncontrollability and danger metacognitions the odds of being in the PTSD group increased 30%, whilst the odds of partial PTSD increased 16%. Stepwise regression analysis using the metacognitive subscales along with demographic and health-related covariates found that uncontrollability/danger and need for control metacognitions explained unique variation in PTSD symptom severity, with unique contributions also for age, sex, and number of comorbidities. PTSD symptoms appeared highly prevalent in the current CR sample. Metacognitive beliefs were individually associated with symptom severity with the strongest positive relationship observed for beliefs about uncontrollability and dangerousness of worry, followed by need to control thoughts. The results highlight the importance in assessing PTSD in CR patients and add support to implementing metacognitive therapy in CHD to target particular metacognition risk factors in anxiety, depression and PTSD.

The Cognitive Profiles of Partial PTSD in Vietnam War Veterans

The Cognitive Profiles of Partial PTSD in Vietnam War Veterans

Mental health impact and mental health care among first responders following the Paris terror attacks in November 2015

Abstract Introduction During the evening of 13 November 2015, a terror attack occurred in France in the Paris area. Overall, 130 people were killed, 643 were injured and several thousands were psychologically impacted. Thousands of first responders (FRs), including health professionals, firefighters, affiliated volunteers and police officers were mobilized that night and during the subsequent weeks. The aims of our study were to measure the psychological impact on FRs, and its associated factors 12 months after the 13 November 2015 terrorist attacks, as well as their engagement in mental health care and its associated factors. Methods FRs who had intervened during the night and/or the aftermath of the terror attacks had the possibility of answering a web-based study 8-12 months after the attacks. They satisfied criterion A of the DSM 5 definition of Post Traumatic Stress Disorder (PTSD). PTSD and partial PTSD were measured using the PTSD checklist for DSM-5 (PCL-5) and depression with the hospital anxiety and depression (HAD) scale. Results Overall, 663 FRs were included in the analysis. Prevalence of PTSD in our sample went from 3.4% among firefighters to 9.5% among police officers. Low educational level, social isolation, intervention on unsecured crime scenes and lack of training were associated with PTSD. Among FRs with PTSD, partial PTSD or depression, 38% sought mental health care. Mental health care engagement was associated with a history of mental health care, post-immediate support and the presence of PTSD, partial PTSD or depression. Conclusions Our results highlight that improving access to mental health care for FRs after terror attacks is needed. Efforts should be made before and after potentially traumatic events to ensure mental health education for FRs. Special attention should be given to FRs living in social isolation, those with low educational levels and those who intervene in unsecured crime scenes.

The application of modern psychophysiological hardware and software complexes in prediction of resistance to combat psychological stress

Modern concepts about the dynamics of states of servicemen following combat mental trauma are presented. Psychological mechanisms of the development of post-traumatic stress disorder are described. The results of psychological examination of servicemen-combatants are briefly summarized. It is shown that 40% of them have negative psychological consequences of combat stress in the form of signs of partial post-traumatic stress disorder, which correlate with manifestations of neurotic disorders. Signs of partial post-traumatic stress disorder in healthy military combatants reduce the self-assessment of the quality of life, but do not significantly affect the professional aspect of social functioning in favorable conditions, that does not allow to identify the presence of negative psychological consequences of combat stress by commander expert assessment.&#x0D; In addition to the psychological examination, the servicemen underwent stress testing on the Rehacor hardware psychophysiological software complex, which consisted in the fact that the subject was alternately presented with stress stimuli consisting of video and audio sequences on the monitor screen and in headphones in accordance with a pre-compiled scenario. In the course of stress testing the physiological parameters of the subject were recorded. In military personnel with signs of partial post-traumatic stress disorder, a decrease in the threshold of sensitivity to stress was found, which in combat conditions can lead to the development of acute stress-induced mental disorders and to be the reason for the growth of violations, mistakes, the adoption of incorrect operational and tactical decisions, the demoralization of personnel, the growth of sanitary and irretrievable losses and losses of military equipment and weapons.&#x0D; Based on the physiological parameters obtained during stress testing, a method for diagnosing signs of partial post-traumatic disorder has been developed. This method makes it possible to objectify the identification of the negative psychological consequences of combat stress and can be used in the interests of psychological and psychiatric intelligence.

Posttraumatic Stress Disorder, Anxiety, and Depression Symptoms After Potentially Traumatic Events: Latent Classes and Cognitive Correlates.

People exposed to potentially traumatic events (PTEs) may develop distinct symptom patterns, which may require different therapeutic approaches. We aimed to identify classes of people exposed to PTEs based on the presence of posttraumatic stress disorder (PTSD) clusters, anxiety, and depression and to explore which cognitive factors (rumination, worry, and negative cognitions) are associated with class membership. Latent class analyses were conducted to identify subgroups of 258 PTE-exposed Spanish adults. A three-class solution emerged: a resilient class with low odds of all symptoms ( n = 188); a partial PTSD class, characterized by partial PTSD clusters, moderate anxiety, and low depression ( n = 36); and a high symptom class, characterized by high PTSD, moderate anxiety, and low depression ( n = 34). These classes related meaningfully to rumination, worry, and negative cognitions. Distinct symptom patterns of PTSD clusters, anxiety, and depression can be distinguished in people exposed to PTEs and relate to cognitive risk factors of psychopathology.

Impact of hormonal contraceptives on sex differences in fear conditioning and fear extinction in PTSD.

Sex differences in the neurobiological mechanisms involved in fear conditioning and extinction have been suggested to contribute to differential vulnerability for the development of posttraumatic stress disorder (PTSD) in women compared with men. Reproductive hormones, such as estradiol, have been shown to facilitate fear conditioning and extinction learning and may explain some of these differences. However, the effect of commonly used hormonal contraceptives on the neurobiological mechanisms of fear conditioning and extinction is poorly understood. A laboratory study was conducted in trauma-exposed men and women with and without full or partial PTSD to examine effects of sex and use of hormonal birth control on fear conditioning, fear extinction learning, and extinction retention. Participants underwent fear conditioning with stimuli that were paired (CS+) or unpaired (CS−) with shock. Extinction learning occurred 72 h later, and extinction retention was tested 1 wk after extinction. Women on hormonal contraceptives (HCs) demonstrated enhanced acquisition of fear conditioning and enhanced extinction of fear as compared with women off hormonal birth control and men. While clinical implications have yet to be determined, these results suggest that hormonal contraceptives may facilitate learning during both fear acquisition and extinction. Understanding the impact of sex and hormones on fear conditioning and extinction processes may lead to new insights into the pathophysiology of PTSD and result in advancements in treatment that may vary by sex.

PTSD and Depression 8 Years After the 2004 Tsunami in Sri Lanka.

To evaluate prevalence and risk factors of posttraumatic stress disorder (PTSD) and depression among directly exposed (DE) and indirectly or nonexposed (INE) populations in Sri Lanka 8 y after the Indian Ocean Tsunami in 2004. Population-based structured survey study was conducted among Sri Lankan adults living in 5 coastal districts, Hamboantha, Matara, Galle, Kalutara, and Colombo in 2012-2013. A total of 430 individuals, 325 in DE, 105 in INE, participated in the survey. DE and INE groups were compared for demographics and outcomes. Bivariate and multiple logistic regressions with backward selection were used to identify risk factors for partial PTSD and depression. The prevalence of PTSD, partial PTSD and depression were 2.8%, 10.5%, and 18.8% in DE group, respectively. In multivariable analyses tsunami exposure, female gender, subjective physical health before the tsunami, previous trauma, and depression were significantly associated with partial PTSD. Female gender, high frequency of religious activity, previous trauma, social support, and PTSD were significantly associated with depression. The psychological impacts of the tsunami did wane over time, but still present at lower rate even in 8 y. It is important to address these lingering sequelae and expand access to at risk individuals.

Post-Traumatic Stress Disorder and Associated Factors among Caregivers of Patients with COVID-19 in Saudi Arabia: A Cross-sectional Study

Background: One of psychological disorders caused by catastrophic life events or severe medical problems is the incidence of post-traumatic stress disorder among people. Different sociodemographic factors have been associated with the development of post-traumatic stress disorder (PTSD). Such research is lacking with COVID-19 especially in the Saudi context.&#x0D; Aim: The purpose of this study was to determine factors associated with PTSD during the outbreak of COVID-19.&#x0D; Materials and Methods: This cross-sectional study was conducted on a convenience sample of 92 Saudi citizens, living in Saudi Arabia, and had at least one relative who had been diagnosed with COVID-19. Data were collected using the impact of event scale (IES-R). SPSS was used to run a multiple linear regression analysis.&#x0D; Results: The results revealed that participants suffered from a partial PTSD. The regression analysis showed a significant relationship between participants’ characteristics and PTSD. The model explained 13.9% of the variance of PTSD (F [5, 77] = 2.49, R2 =.139, p&lt; .05). Two predictors of gender (p&lt;.01) and level of education (p&lt;.05) were statistically significant to the prediction. Male participants had higher PTSD scores than female participants (beta = -9.19, t = -2.73, p&lt; .01). Also, those caregivers with low level of education had higher PTSD levels (beta = 3.279, t = 2.30, p &lt;.05).&#x0D; Conclusion: The current study demonstrated a strong association between participants’ demographic characteristics (namely gender and level of education) and PTSD. A lack of information and the evolution of the COVID-19 outbreak may be important factors in increasing people’s levels of PTSD. Therefore, future research aiming to find appropriate solutions to such issues is recommended.

Three-Month Follow-up Study of Mental Health Outcomes After a National COVID-19 Lockdown: Comparing Patients With Mood or Anxiety Disorders Living in an Area With a Higher Versus Lower Infection Incidence.

Objective: The COVID-19 pandemic and the related containment measures can represent a traumatic experience, particularly for populations living in high incidence areas and individuals with mental disorders. The aim of this study was to prospectively examine posttraumatic stress disorder (PTSD), anxiety, and depressive symptoms since the end of the first COVID-19 pandemic wave and Italy's national lockdown in subjects with mood or anxiety disorders living in 2 regions with increasing pandemic incidence.Methods: 102 subjects with a DSM-5 anxiety or mood disorder were enrolled from June to July 2020 and assessed at baseline (T0) and after 3 months (T1) with the Impact of Event Scale-Revised, Patient Health Questionnaire-9, Generalized Anxiety Disorder 7-Item, and Work and Social Adjustment Scale. At T1, subjects were also assessed by means of the Trauma and Loss Spectrum Self-Report for PTSD.Results: At T0, subjects from the high COVID-19 incidence area showed higher levels of traumatic symptoms than those from the low COVID-19 incidence area (P < .001), with a decrease at T1 with respect to T0 (P = .001). Full or partial DSM-5 PTSD related to the COVID-19 pandemic emerged in 23 subjects (53.5%) from the high COVID-19 incidence area and in 9 (18.0%) from the low COVID-19 incidence area (P < .001).Conclusions: Subjects with mood or anxiety disorders presented relevant rates of PTSD, depressive, and anxiety symptoms in the aftermath of the lockdown, and in most cases these persisted after 3 months. The level of exposure to the pandemic emerged as a major risk factor for PTSD development. Further long-term studies are needed to follow up the course of traumatic burden.