Post-traumatic Spectrum Symptoms Research Articles

Gene Therapy in Erectile Dysfunction: Dead or Alive?

Mental disorders are frequently related to sexual dysfunction (SD) but scant data are still available on trauma-related disorders, particularly post-traumatic stress disorder (PTSD).To evaluate the relationships between SD and PTSD in 2009 L'Aquila (Italy) earthquake young adult survivors, with particular attention to gender differences.Five hundred twelve high-school senior students were assessed 21 months after exposure by the following: Trauma and Loss Spectrum–Self-Report (TALS-SR), for post-traumatic spectrum symptoms; Mood Spectrum–Self-Report (MOODS-SR) lifetime version, for mood spectrum symptoms (including SD-related symptoms). Descriptive and inferential statistics were adopted.TALS-SR and MOODS-SR scores were analyzed to evaluate PTSD- and SD-related symptoms.Around 6.5% of subjects reported SD-related symptoms with males showing higher rates than females in each symptom, with a statistically significant difference in item n = 154 (…less sexually active). Survivors with symptomatological PTSD reported rates up to 10%, with higher ratio of endorsing at least one SD-related symptom than with NO-PTSD. Significantly higher total MOODS-SR SD-related symptom scores emerged in survivors with symptomatological PTSD than in those with NO-PTSD, and a 2-way ANOVA showed a significant main effect of symptomatological PTSD and gender and gender × PTSD interaction.SD-related symptoms are reported among young adult survivors to earthquake exposure and the number of symptoms is related to PTSD, particularly in males, suggesting the need for accurate evaluation.Strengths are the large sample of young adult survivors to a massive natural disaster; the long-time frame from exposure corroborating the role of PTSD; the assessment of symptoms specifically occurring after exposure. Limitations are as follows: the lack of a specific scale for SD; the self-report instruments other than clinical interviews, that may be less accurate; the lack of information on the presence of somatic illness and other mental disorders; the lack of a control group; the young age of the sample because of the lifetime sexual experiences of the subjects, in addition to the lack of a comparison measure of sexual functioning before the earthquake.Our results highlight relevant rates of SD-related symptoms in young adults exposed to the L'Aquila earthquake, particularly males and subjects with PTSD, suggesting SD may represent a specific male gender–related somatic complaint. Our results highlight the need for accurate investigation of SD in such population to improve clinical management and appropriate treatment.Carmassi C, Dell'Oste V, Pedrinelli V, et al. Is Sexual Dysfunction in Young Adult Survivors to the L'Aquila Earthquake Related to Post-traumatic Stress Disorder? A Gender Perspective. J Sex Med 2020;17:1770–1778.

Is Sexual Dysfunction in Young Adult Survivors to the L‘Aquila Earthquake Related to Post-traumatic Stress Disorder? A Gender Perspective

BackgroundMental disorders are frequently related to sexual dysfunction (SD) but scant data are still available on trauma-related disorders, particularly post-traumatic stress disorder (PTSD). AimTo evaluate the relationships between SD and PTSD in 2009 L'Aquila (Italy) earthquake young adult survivors, with particular attention to gender differences. MethodsFive hundred twelve high-school senior students were assessed 21 months after exposure by the following: Trauma and Loss Spectrum–Self-Report (TALS-SR), for post-traumatic spectrum symptoms; Mood Spectrum–Self-Report (MOODS-SR) lifetime version, for mood spectrum symptoms (including SD-related symptoms). Descriptive and inferential statistics were adopted. OutcomesTALS-SR and MOODS-SR scores were analyzed to evaluate PTSD- and SD-related symptoms. ResultsAround 6.5% of subjects reported SD-related symptoms with males showing higher rates than females in each symptom, with a statistically significant difference in item n = 154 (…less sexually active). Survivors with symptomatological PTSD reported rates up to 10%, with higher ratio of endorsing at least one SD-related symptom than with NO-PTSD. Significantly higher total MOODS-SR SD-related symptom scores emerged in survivors with symptomatological PTSD than in those with NO-PTSD, and a 2-way ANOVA showed a significant main effect of symptomatological PTSD and gender and gender × PTSD interaction. Clinical ImplicationsSD-related symptoms are reported among young adult survivors to earthquake exposure and the number of symptoms is related to PTSD, particularly in males, suggesting the need for accurate evaluation. Strengths & LimitationsStrengths are the large sample of young adult survivors to a massive natural disaster; the long-time frame from exposure corroborating the role of PTSD; the assessment of symptoms specifically occurring after exposure. Limitations are as follows: the lack of a specific scale for SD; the self-report instruments other than clinical interviews, that may be less accurate; the lack of information on the presence of somatic illness and other mental disorders; the lack of a control group; the young age of the sample because of the lifetime sexual experiences of the subjects, in addition to the lack of a comparison measure of sexual functioning before the earthquake. ConclusionsOur results highlight relevant rates of SD-related symptoms in young adults exposed to the L'Aquila earthquake, particularly males and subjects with PTSD, suggesting SD may represent a specific male gender–related somatic complaint. Our results highlight the need for accurate investigation of SD in such population to improve clinical management and appropriate treatment.Carmassi C, Dell'Oste V, Pedrinelli V, et al. Is Sexual Dysfunction in Young Adult Survivors to the L'Aquila Earthquake Related to Post-traumatic Stress Disorder? A Gender Perspective. J Sex Med 2020;17:1770–1778.

Impact and Prevalence of Physical and Verbal Violence Toward Healthcare Workers

Threatening and assaultive behaviors against healthcare workers are a growing national concern.1,2,3 OBJECTIVE: To assess the incidence and impact of aggression against healthcare workers, a safety and quality improvement project was initiated in an academic, tertiary care, urban hospital. Through the Northwestern Academy of Quality and Safety Initiatives program, an invitation to complete an online survey was sent to healthcare workers. The survey inquired about prevalence, location, and type of experience of physical or verbal abuse by patients or families. Other goals were: 1) worker knowledge and use of reporting systems, 2) effect on healthcare worker engagement, and 3) report of posttraumatic symptoms. 34.4% of healthcare workers reported any incident of verbal or physical violence in the preceeding 12 months, with 13.5% reporting physical assault. Of those with any incident of physical or verbal violence, 60.2% endorsed at least one posttraumatic symptom, 9.4% missed work, and 30.1% had thoughts about leaving their job or career. The reported impact was the same for physical or verbal incidents. Physical and verbal abuse of healthcare workers is prevalent and has a significant impact on employee engagement and posttraumatic spectrum symptoms. These results are based on a cross-sectional survey at one institution and may have a significant selection and response bias. Assessment of both verbal and physical aggression against healthcare workers should be standard. Front-line consulting psychiatrists and psychiatric programs for employee wellness could assess and manage this impact.

Clinical correlates of plasma brain-derived neurotrophic factor in post-traumatic stress disorder spectrum after a natural disaster.

Clinical correlates of plasma Brain-Derived Neurotrophic Factor (BDNF) have been investigated in a clinical population with Post Traumatic Stress Disorder (PTSD) symptoms and healthy control subjects who survived to the L'Aquila 2009 earthquake. Twenty-six outpatients and 14 control subjects were recruited. Assessments included: Structured Clinical Interview for DSM-IV Axis-I disorders Patient Version, Trauma and Loss Spectrum-Self Report (TALS-SR) for post-traumatic spectrum symptoms. Thirteen patients were diagnosed as Full PTSD and 13 as Partial PTSD. The subjects with full-blown PTSD showed lower BDNF level than subjects with partial PTSD and controls. Different relationship patterns of BDNF with post-traumatic stress spectrum symptoms have been reported in the three samples. Our findings add more insight on the mechanisms regulating BDNF levels in response to stress and further proofs of the utility of the distinction of PTSD into full and partial categories.

P-963 - Relationships between post-traumatic spectrum symptoms and age, gender and degree of exposure to the l’aquila 2009 earthquake

PTSD and post-traumatic spectrum symptoms represent the most frequently reported psychiatric sequelae of earthquakes and several studies have investigated the role of risk factors1,2. Aim of the present study was to explore PTSD and post-traumatic spectrum symptoms in L’Aquila (Italy) 2009 earthquake survivors and their correlations with age, gender and degree of exposure. 1488 subjects were investigated by means of the TALS-SR5. The total sample was divided, by random extraction, in 8 homogenous subgroups comparable for gender, age (≤40 vs >40 years) and direct/indirect exposure to the earthquake. 41.3% of exposed subjects presented PTSD vs 16.6% of not exposed. Women reported significantly higher PTSD prevalence rates and post-traumatic spectrum symptoms than men. Exposed subjects reported higher PTSD rates both in the whole sample and in all subgroups, with the only exception of younger men. Our results confirm different vulnerability to PTSD after earthquake on the basis of gender, age and degree of exposure.

P-1383 - Correlations between post-traumatic spetrum symptoms and serum neurosteroids levels in patients with ptsd and healthy control subjects

Many studies have explored the relationship between abnormalities of the hypothalamic-pituitary-adrenal (HPA) and anxiety disorders, nevertheless data on post-traumatic stress conditions are still controversial. To find a link between neurosteroids alterations and PTSD. To explore cortisol and dehydroepiandrosterone sulfate (DHEA-S) serum levels in a sample of patients with post-traumatic stress disorder (PTSD), recruited from the general population, compared with a group of healthy control subjects. We recruited 26 patients with PTSD (mean age: 43.69 ± 10.03 years), assessed by the SCID-I / P for the DSM-IV-TR diagnosis, and 26 healthy control subjects (mean age: 42.12 ± 10.39 years), without current or lifetime psychiatry disorders. The neurosteroid levels were measured in 10 ml of venous blood, between 9 and 10 am, at least 2 hours after awakening to minimize the physiological increase of cortisol in the morning. Patients and controls were assessed by Trauma and Loss Spectrum Self-Report [5] . Significantly lower cortisol levels, but not DHEA-S, were detected in patients with PTSD (c 2 = 15.97, p < .001) compared with control subjects. In addition, significant correlations emerged with domains of the TALS-SR. Our results confirm the existence of a relationship between alterations in HPA axis and post-traumatic spectrum symptoms, although further studies are needed.

Impact of traumatic loss on post-traumatic spectrum symptoms in high school students after the L'Aquila 2009 earthquake in Italy

On April 6th 2009, the town of L'Aquila, Italy, was struck by an earthquake (6.3 on the Richter scale) that lead large parts of the town to be destroyed and the death of 309 people. Significant losses in the framework of earthquakes have been reported as a major risk factor for PTSD development. Aim of this study was to investigate post-traumatic spectrum symptoms in a sample of adolescents exposed to the L'Aquila 2009 earthquake 21 months earlier, with particular attention to the impact of loss. 475 students (203 women and 272 men), attending the last year of High School in L'Aquila, were assessed by: Trauma and Loss Spectrum-Self Report (TALS-SR) and Impact of Event Scale (IES). The presence of full and partial PTSD was also assessed. 72 students (15.2%) reported the loss of a close friend or relative in the framework of the earthquake. Full PTSD was reported by 146 (30.7%) students and partial PTSD by 149 (31.4%) students. There was a significant difference reported in PTSD between bereaved and non bereaved subjects. Significantly higher post-traumatic symptom levels were reported by bereaved subjects. The lack of information on the relationship with the deceased and the number of losses experienced, besides the use of self report instruments are the limitations of this study. Our results show high rates of post-traumatic spectrum symptoms in adolescents who survived the L'Aquila earthquake. Having experienced the loss of a close friend or a relative in the framework of the earthquake seems to be related to higher PTSD rates and more severe symptomatology. These results highlight the need to carefully explore adolescents exposed to a significant loss as consequence of an earthquake.