Posttraumatic Distress Disorder Research Articles

The mental health and well-being implications of a mesothelioma diagnosis: A mixed methods study

PurposeMesothelioma is an incurable, asbestos-related cancer with a poor prognosis. There is scant evidence about the mental health and well-being impacts on patients and carers living with the illness. This study aimed to investigate mesothelioma's impact on mental health and well-being and the scale of mental health conditions in patients and informal carers. MethodsA mixed-methods design was used: a cross-sectional survey of mesothelioma patients and informal carers plus semi-structured interviews with patients and carers. The survey used validated scales collecting data on mental health aspects of mesothelioma: the EQ5D to assess health-related quality-of-life; the Hospital Anxiety and Depression scale; the PCL-5 to assess Posttraumatic Stress; and the Posttraumatic Growth Inventory. The datasets were integrated during analysis. Results96 useable survey responses were received. A clinical level of depression was reported by 29 participants (30.21%), of anxiety by 48 (50%), of posttraumatic distress disorder by 32 (33.33%), and of posttraumatic growth by 34 (35.42%). Carers had worse scores than patients. Three main themes were developed from interviews with 10 patients and 11 carers: ‘Prognosis’, ‘Support from services’, and ‘Social connections and communication’. ConclusionsHealthcare professionals delivering a mesothelioma diagnosis require regular training in communication skills plus updating in current treatment options, so they provide an appropriate mix of realism and hope. Better signposting to mental health support is needed for patients and carers. Our introduction of posttraumatic growth into the mesothelioma literature is novel. We recommend specialist nurses are trained to recognise, understand, and foster posttraumatic growth.

The prevalence of mental frailty in ICU survivors and informal caregiver strain: A 1-year retrospective study of the Frisian aftercare cohort.

Intensive care unit (ICU) survivors often suffer from long-term mental problems and a reduced health-related quality of life (HRQoL). Symptoms of depression, anxiety, and post-traumatic stress disorder may render patients mentally frail post-ICU, resulting in impaired recovery and an increased informal caregiver burden. The aim of this study was to investigate the prevalence of mental frailty up to 12 months after ICU admission and pinpoint markers for early risk-assessment in clinical practice. A retrospective cohort study (2012-2018) in which clinical and post-ICU data of long-stay (⩾48 h) ICU-patients was used. Mental frailty was identified as clinically relevant symptoms of depression, anxiety, or post-traumatic distress disorder at 12 months after discharge. The prevalence of mental frailty at 12 months post-ICU among the total group of 239 patients was 38%. Mental frailty was defined as clinically relevant symptoms of depression, anxiety, and/or trauma. To achieve this, previously validated cut off values were used for the HADS (HADS-Anxiety ⩾ 8; HADS-Depression ⩾ 8) and TSQ (⩾6), and CSI (⩾7). A significant proportion of ICU-survivors can be identified as mentally frail, which is associated with impaired HRQoL at baseline and post-ICU, and high caregiver strain. These findings emphasize the need for integrative aftercare programs for both the patient and their informal caregivers.

PLAYING THERAPY CAN REDUCE POST TRAUMATIC STRESS DISORDER (PTSD) IN POST-EARTHQUAKE CHILDREN

Earthquakes lead to Post Traumatic Distress Disorder (PTSD), which is psychological stress trauma after a disaster. Management of PTSD in children is playing therapy. This study aimed to determine the effect of Playing Therapy on Post Traumatic Stress Disorder(PTSD) in children aged 7-12. This research was an experimental research with one group pre-test and post-test design. Thirty-five respondents had PTSD symptoms after the earthquake in Malunda, Majene. The research instrument used was a questionnaire. This study found a significant decrease in PTSD, with p-value = 0.001 = 0.05. It can be concluded that playing therapy affected decreasing Post Traumatic Stress Disorder (PTSD) in children aged 7-12 years who were the earthquake victims in Mekkatta Village, Malunda District.

Coping strategies in patients with acute myeloid leukemia

AbstractPatients diagnosed with acute myeloid leukemia (AML) face sudden-onset life-threatening disease that requires intensive treatments. Although their early disease trajectory is characterized by significant, toxic side effects, limited data are available describing coping strategies among patients with AML and how these inform patient-reported outcomes. We used cross-sectional secondary data analyses to describe coping in 160 patients with newly diagnosed high-risk AML. The Brief COPE, Hospital Anxiety and Depression Scale, Post-Traumatic Stress Disorder Checklist–Civilian Version, and Functional Assessment of Cancer Therapy–Leukemia were used at time of AML diagnosis to measure coping strategies, psychological distress, and quality of life (QOL), respectively. The median split method for distribution of coping domains and multivariate regression models were used to assess the relationship between coping and patient-reported outcomes. Participants (median age, 64.4 years) were mostly non-Hispanic White (86.3%), male (60.0%), and married (73.8%). Most (51.9%) had high utilization of approach-oriented coping strategies, whereas 38.8% had high utilization of avoidant coping strategies. At time of diagnosis, use of approach-oriented coping was associated with less psychological distress (anxiety, β = –0.262, P = .002; depression symptoms, β = –0.311, P < .001; and posttraumatic distress disorder symptoms, β = –0.596, P = .006) and better QOL (β = 1.491, P = .003). Use of avoidant coping was associated with more psychological distress (anxiety, β = 0.884, P < .001; depression symptoms, β = 0.697, P < .001; and posttraumatic distress disorder symptoms, β = 3.048, P < .001) and worse QOL (β = –5.696, P < .001). Patients with high-risk AML use various approach-oriented and avoidant coping strategies at time of diagnosis. Use of approach-oriented coping strategies was associated with less psychological distress and better QOL, suggesting a possible target for supportive oncology interventions.

Isolation, self-blame and perceived invalidation in aid personnel: identifying humanitarian-specific distress using the PostAID/Q

ObjectiveHumanitarian-specific psychological distress following deployment can elude detection using contemporary measures of trauma-related stress. This study assesses the unidimensional structure and convergent validity of the Post-deployment Altruistic Identity Disruption Questionnaire (PostAID/Q), an 18-item questionnaire underpinned by the construct Altruistic Identity/Disruption (AI/AID).MethodHumanitarian aid personnel (N=108) completed an online web survey, inclusive of the Moral Injury Questionnaire (MIQ), Posttraumatic Distress Disorder Checklist (PCL-5), Psychological Well-Being Posttraumatic Changes Questionnaire (PWB-PTCQ) and Social Provisions Scale (SPS).ResultsA confirmatory factor analysis suggested a single factor structure providing further support for the conception of AI/AID as a unidimensional construct. Convergent validity was demonstrated through (1) utility for predicting a posttraumatic stress disorder (PTSD) diagnosis assessed by the PCL-5, and (2) moral injury assessed by the MIQ. The PostAID/Q was further moderately and negatively associated with the availability of social support (assessed by the SPS) and lower self-reports of psychological well-being post trauma (assessed by the PWB-PCTQ). Finally, the PostAID/Q demonstrated evidence of incremental validity in predicting humanitarian specific psychological distress over and above the PCL-5. Specifically, the PostAID/Q predicted increased moral injury on the MIQ, and decreased psychological well-being post trauma.ConclusionsThe PostAID/Q can assist in identifying humanitarian specific psychological responses post deployment guiding support for personnel, over and above more traditional measures of posttraumatic stress.

THE SYRIAN WAR AND POST-TRAUMATIC STRESS DISORDER

Purpose of the Study: The purpose of this study is to investigate the prevalence of posttraumatic distress disorder (PTSD) amongst Syrian whom lived in under the war.&#x0D; Methodology: The study has utilized a survey to observe the prevalence of post-traumatic stress disorder (PTSD) among Syrian people who lived inside Syria during the Syrian conflict The survey uses the PTSD checklist for civilians (PCL-C), which measures both the severity of PTSD and the 3 symptoms of it in accordance with “The Diagnostic and Statistical Manual of Mental Disorders” (DSM-IV) that are re-experiencing; avoidance; and hyperarousal. A sample of 600 random Syrian people participated in the current study.&#x0D; &#x0D; Findings: The PTSD test results show a widespread of the trauma in Syria based on the result of the test as 53percent of the participants had symptoms corresponding to the recommended diagnosis, which is expected due to horrors of war and terrorism-related events.&#x0D; Implications: Results suggest that it is imperative to provide intervention programs to treat PTSD symptoms among people who live in Syria. The participants' cultural and religious backgrounds should be taken into account in these programs.&#x0D; The originality of the Study: This Syrian war research has contributed to a spike in symptoms of PTSD and depression among children in Syria.

THE PREVALENCE OF PTSD AND DEPRESSION AMONG GAZA CHILDREN

Purpose: The purpose of this study is to investigate the prevalence of posttraumatic distress disorder (PTSD) and depression among children in Gaza, Palestine.&#x0D; Methodology: This study assessed the psychological effects of the Israeli-Palestinian conflict on children in the Gaza Strip. 286 children aged 9-14 years old, who were exposed to a wide range of war events, were selected from the Gaza Strip to participate in this study. All participants conducted the following scales: the child PTSD Reaction Index(CPTSD-RI), Beck Depression Inventory (BDI), and the Arabic version for PTSD and depression assessment.&#x0D; Finding: The results show that the mean number of participants witnessing home destroyed and people killed was (88%) and home invasion (76%). Approximately 70% of the participants reported that they witnessed war violence against at least one of their family members. Further, 44 % of the children have a least one death in their family due to the Israeli invasion. Using t-tests, we found that significantly more females have both PTSD and depression than males. Approximately 32.8% of the participants met the criteria for severe depression, and 42.6 % met the criteria for PTSD.&#x0D; Implications: Our results suggest that it is imperative to provide intervention programs to treat PTSD and depression symptoms among children in Gaza. These programs should take into account the cultural and religious background of the participants.&#x0D; Originality: This investigation of the Israeli-Palestinian conflict has led to an increase in PTSD and depression symptoms among children in the Gaza Strip.

PTSD, Complex PTSD, and Childhood Abuse: Gender Differences among a Homeless Sample

The current study examined the potential relationship between homelessness, gender, and occurrence of Post-Traumatic Distress Disorder (PTSD) and Complex PTSD. Participants were 90 homeless persons from shelters located in a large, South Central Texas, metropolitan city of approximately 1.9 million persons. The study found that homeless participants reported high levels of childhood emotional, physical, and sexual abuse. Homeless women reported higher rates of childhood abuse and were affected by PTSD at a higher frequency than homeless males. PTSD, Complex PTSD, and traumatic experiences such as childhood abuse appear to be contributing factors to homelessness. Results suggest the need for increased advocacy among counseling and psychology professionals is warranted for homeless persons experiencing PTSD.

Add-on atypical anti-psychotic treatment alleviates auditory verbal hallucinations in patients with chronic post-traumatic stress disorder

Auditory verbal hallucinations are common symptoms of post traumatic distress disorder. Previous studies have demonstrated alterations in the salience network (SN) in patients with post traumatic distress disorder and that hyperactivity of the SN is associated with AVHs in patients with psychosis. Patients with post traumatic distress disorder may benefit from aripiprazole; however, studies investigating the effect of aripiprazole on AVHs and activity in the SN in patients with post traumatic distress disorder are scarce. Therefore, we conducted an outcomes analysis using functional magnetic resonance imaging to explore the effects of add-on aripiprazole treatment on AVHs and brain functional connectivity in patients with post traumatic distress disorder. AVHs were alleviated by add-on aripiprazole treatment (Auditory Hallucination Rating Scale [AHRS] score reduced by ≥ 50%) in 22.7% of patients. Functional activity in the SN was obviously decreased in patients in whom AHRS scores were reduced ≥ 50% following add-on aripiprazole treatment compared to patients in whom AHRS scores were reduced by <50%. The decrease in functional connectivity within the SN was significantly correlated with the reduction in total AHRS scores. Although this study was associated with several limitations, the findings suggest that add-on aripiprazole treatment can alleviate AVHs in patients with post traumatic distress disorder by reducing activity in the SN.

Understanding the relationship between social support and posttraumatic stress disorder/posttraumatic growth among adolescents after Ya'an earthquake: The role of emotion regulation.

Posttraumatic distress disorder (PTSD) and posttraumatic growth (PTG) may coexist in trauma survivors, but there are mixed relationships between PTSD and PTG. To elucidate their relationship and constructs, it is necessary to examine simultaneously predictive factors, and to compare their determining factors. The aim of this study was to increasing our understanding the relationship between PTSD and PTG by examining simultaneously the role of social support and emotion regulation in PTSD and PTG among adolescents after the earthquake. Six months after the Ya'an earthquake, 315 middle school students in Lushan county were assessed using measures of trauma exposure, social support, and emotion regulation, as well as Child PTSD Symptom Scale and Posttraumatic Growth Inventory. Social support had significant direct association with PTG but not with PTSD, but social support had a negative indirect prediction on PTSD and a positive indirect prediction on PTG through cognitive reappraisal. Social support, through expressive suppression, had a significant and indirect prediction on PTSD, but a nonsignificant indirect prediction on PTG. This study indicate that the predictive mechanism of PTSD and PTG were different and further suggest that PTSD and PTG are separate, independent dimensions of psychological experiences following adversity. (PsycINFO Database Record

The Impact of Disclosure of Intimate Partner Violence on Friends

These findings suggest that even though the same dimensions have been found in both a U.S. and an Indian sample, how disclosure of IPV on friends relates to psychological symptoms may differ. This study suggest that there is at least some overlap in the experiences of friends of IPV and SA survivors, but that certain dimensions of the measure may have different relationships to other phenomena in different cultures.

Depression, post-traumatic stress disorder, and functional disability in survivors of critical illness in the BRAIN-ICU study: a longitudinal cohort study

Critical illness is associated with cognitive impairment, but mental health and functional disabilities in survivors of intensive care are inadequately characterised. We aimed to assess associations of age and duration of delirium with mental health and functional disabilities in this group. In this prospective, multicentre cohort study, we enrolled patients with respiratory failure or shock who were undergoing treatment in medical or surgical ICUs in Nashville, TN, USA. We obtained data for baseline demographics and in-hospital variables, and assessed survivors at 3 months and 12 months with measures of depression (Beck Depression Inventory II), post-traumatic stress disorder (PTSD, Post-Traumatic Stress Disorder Checklist-Event Specific Version), and functional disability (activities of daily living scales, Pfeffer Functional Activities Questionnaire, and Katz Activities of Daily Living Scale). We used linear and proportional odds logistic regression to assess the independent associations between age and duration of delirium with mental health and functional disabilities. This study is registered with ClinicalTrials.gov, number NCT00392795. We enrolled 821 patients with a median age of 61 years (IQR 51-71), assessing 448 patients at 3 months and 382 patients at 12 months after discharge. At 3 months, 149 (37%) of 406 patients with available data reported at least mild depression, as did 116 (33%) of 347 patients at 12 months; this depression was mainly due to somatic rather than cognitive-affective symptoms. Depressive symptoms were common even among individuals without a history of depression (as reported by a proxy), occurring in 76 (30%) of 255 patients with data at 3 months and 62 (29%) of 217 individuals at 12 months. Only 7% of patients (27 of 415 at 3 months and 24 of 361 at 12 months) had symptoms consistent with post-traumatic distress disorder. Disabilities in basic activities of daily living (ADL) were present in 139 (32%) of 428 patients at 3 months and 102 (27%) of 374 at 12 months, as were disabilities in instrumental ADL in 108 (26%) of 422 individuals at 3 months and 87 (23%) of 372 at 12 months. Mental health and functional difficulties were prevalent in patients of all ages. Although old age was frequently associated with mental health problems and functional disabilities, we observed no consistent association between the presence of delirium and these outcomes. Poor mental health and functional disability is common in patients treated in intensive-care units. Depression is five times more common than is post-traumatic distress disorder after critical illness and is driven by somatic symptoms, suggesting approaches targeting physical rather than cognitive causes could benefit patients leaving critical care. National Institutes of Health AG027472 and the Geriatric Research, Education and Clinical Center (GRECC), Department of Veterans Affairs Medical Center, Tennessee Valley Healthcare System.

Psychiatric comorbidity of patients on methadone maintenance treatment with a history of sexual abuse

The aim of this study was to assess the prevalence of a history of sexual abuse and its relation to psychiatric comorbidity among former opiate addicts currently on methadone maintenance treatment (MMT). We evaluated the history of sexual abuse and current clinical obsessive compulsive disorder (OCD), dissociative identity disorder (DID), and complex posttraumatic distress disorder (cPTSD), and administered the Life Events Inventory Questionnaire among 125 MMT patients (76 females and 49 males). Eighty (64%) patients had experienced sexual abuse, 69 (55.2%) met the criteria for clinical OCD, 20 (16.0%) for cPTSD and 13 (10.4%) for DID. More females had clinical OCD than males (63.2% vs. 42.9%, respectively, p=0.03). Sexually abused patients had higher rates of clinical OCD than their non-abused counterparts (67.5% vs. 33.3%, respectively, p<0.0005) and a higher mean number of negative life events (8.0±2.0 vs. 7.1±1.8, p=0.01). Sexually abused patients showed a trend towards a higher Dissociative Experiences Scale score (17.6±10.1 vs. 14.6±8.1, p=0.08) and rate of DID (13.8% vs. 4.4%, p=0.1), but no significant difference in the rate of cPTSD (17.5% vs. 13.3%, p=0.6) compared to non-abused subjects. The 80 sexually abused patients were mostly female (85%), and 57.5% of them were abused by a family member. In summary, more sexually abused MMT patients were diagnosed with clinical OCD and fewer with cPTSD and DID. Those with cPTSD were characterized by more negative life events, higher dissociation scores, and assaults by a family member. We conclude that sexually abused MMT patients should be screened for clinical OCD.

Death by request in Switzerland: Posttraumatic stress disorder and complicated grief after witnessing assisted suicide

BackgroundDespite continuing political, legal and moral debate on the subject, assisted suicide is permitted in only a few countries worldwide. However, few studies have examined the impact that witnessing assisted suicide has on the mental health of family members or close friends. MethodsA cross-sectional survey of 85 family members or close friends who were present at an assisted suicide was conducted in December 2007. Full or partial Post-Traumatic Distress Disorder (PTSD; Impact of Event Scale–Revised), depression and anxiety symptoms (Brief Symptom Inventory) and complicated grief (Inventory of Complicated Grief) were assessed at 14 to 24 months post-loss. ResultsOf the 85 participants, 13% met the criteria for full PTSD (cut-off≥35), 6.5% met the criteria for subthreshold PTSD (cut-off≥25), and 4.9% met the criteria for complicated grief. The prevalence of depression was 16%; the prevalence of anxiety was 6%. ConclusionA higher prevalence of PTSD and depression was found in the present sample than has been reported for the Swiss population in general. However, the prevalence of complicated grief in the sample was comparable to that reported for the general Swiss population. Therefore, although there seemed to be no complications in the grief process, about 20% of respondents experienced full or subthreshold PTSD related to the loss of a close person through assisted suicide.

Effects of hydrocortisone on posttraumatic stress disorder after septic shock: results from the CORTICUS Berlin Study Group

Posttraumatic distress disorder (PTSD) and impaired heath-related quality of life (HRQoL) are important outcome parameters of ICU treatment. There is evidence that PTSD is associated with dysregulation of the hypothalamus pituitary adrenal axis [1]. Administration of hydrocortisone (HC) during ongoing trauma might be protective for PTSD [2]. PTSD and HRQoL were prospectively evaluated in septic shock patients enrolled in a substudy of the CORTICUS trial.